Palliative Treatment of Inoperable Malignant Esophageal Strictures With Conically Shaped Covered Self-Expanding Stents

Poyanlı, Arzu; Sencer, Serra; Rozanes, İzzet; Acunaş, Bülent

doi:10.1034/j.1600-0455.2001.042002166.x

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Although we placed stents 5–8 cm longer than the stricture, the overgrowth of stent borders by tumor tissue occurred in both groups of patients (Table 2). Other authors’ results are similar: the frequency of overgrowth ranges from 2% to 25% in different series 11,20,46–48 …”

Section: Discussionsupporting

confidence: 64%

Fluoroscopically guided insertion of self-expandable metal esophageal stents for palliative treatment of patients with malignant stenosis of esophagus and cardia: comparison of uncovered and covered stent types

Šaranović¹,

Djurić-Stefanović²,

Ivanović³

et al. 2005

Diseases of the Esophagus

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The aim of this retrospective study was to present and compare the results of using two different types of esophageal self-expanding stents (uncovered and covered) for palliative treatment of patients with inoperable malignant stenosis of the esophagus and cardia. Over a period of 8 years, 152 patients underwent fluoroscopically guided insertion of metal esophageal stents. We inserted uncovered esophageal nitinol Strecker stents in 54 patients (group I) and covered esophageal Ultraflex stents in the remaining 98 patients (group II). The stent insertion procedure was successively performed in all patients. Closure of esophageal fistula by covered stents was achieved in 8/8 patients. Mean dysphagia score was significantly decreased in both patient groups at 4 weeks follow-up: from 2.73 before stent insertion to 0.15 in group I, and from 2.67 to 0.05 in group II (on 0-4 scale). Eighty-eight per cent of patients with covered stents and 54% with uncovered type were free of symptoms during follow-up. Complications occurring during follow-up and their comparative frequency in the two groups of patients were as follows (group I: group II%): stent migration (0 : 10%); tumor or granulation tissue ingrowth (100 : 53%); overgrowth at the ends of stents (17 : 30%); restenosis causing recurrent dysphagia (37 : 8%); and appearance of esophageal fistulas (8 : 6%). In conclusion, fluoroscopically guided insertion of self-expandable esophageal stents is a safe and comfortable method of palliation for patients suffering with malignant dysphagia. In selection of a stent, covered types should be given priority for prevention of restenosis.

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Section: Discussionsupporting

confidence: 64%

Fluoroscopically guided insertion of self-expandable metal esophageal stents for palliative treatment of patients with malignant stenosis of esophagus and cardia: comparison of uncovered and covered stent types

Šaranović¹,

Djurić-Stefanović²,

Ivanović³

et al. 2005

Diseases of the Esophagus

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“…There was no difference in improvement in dysphagia score between the two groups but there were more major complications in the large diameter compared to the small diameter stent (5 versus 2 respectively) and the incidence of recurrent dysphagia of 25 % is similar to that occurring with conventional SEMS in other studies. A further descriptive study of 40 consecutive patients treated with Flamingo SEMS reported a complication rate of 7.5 % with only one case of tumour ingrowth [34]. Clearly further trials are needed which are randomised, controlled and with blinded assessment of response.…”

Section: New Sems Designmentioning

confidence: 99%

“…The advent of covered SEMS has been a significant advance in the palliation of malignant tracheo-oesophageal fistula and have become the treatment of choice. Technical success rates in the covering of fistulae are high, with complication rates similar to that of non-fistulating oesophageal cancer [23,25,28,34], however enlargement of fistula or formation of further fistulae may occur [25]. For patients with both oesophageal and tracheobronchial stenosis without fistula, the tracheobronchial stenosis should be stented first to prevent respiratory distress with placement of oesophageal stent [54].…”

Section: Tracheo-oesophageal Fistulamentioning

confidence: 99%

Treatment of Oesophago-Gastric Tumours

Leiper¹,

Morris²

2002

Endoscopy

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The incidence of oesophageal adenocarcinoma continues to rise rapidly in the West whereas cancer of the stomach is becoming less common. Most patients present with advanced disease that is not amenable to curative treatment. This review focuses on recent evidence on the endoscopic therapy of oesophago-gastric cancer. Although there are many treatment modalities available, there is a paucity of good quality randomised trial evidence on which to base palliative treatment decisions. Furthermore, although palliation of dysphagia may be improved by expandable metal stents or ablative therapy, there is no evidence that this improves survival and each of these therapies has a high frequency of complications particularly in longterm survivors. Exciting developments have however been reported in the therapy of early stage oesophago-gastric cancer. Endoscopic mucosal resection is particularly promising with high rates of complete removal of early cancer or high grade dysplasia. Long-term follow up of these patients is required because of high rates of metachronous tumour formation and at present there are no randomised trial data comparing endoscopic mucosal resection with conventional surgery.

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“…No migration was noted, but more major complications occurred in the patients with the largediameter stents as compared with the group having the small-diameter stents (5 vs. 2, respectively). Another descriptive study of 40 consecutive patients treated with Flamingo stents reported a complication rate of 7.5 % with only 1 case of tumor ingrowth, but no migrations [91].…”

Section: Stent Migrationmentioning

confidence: 99%

Stenting in Esophageal Strictures

Petruzziello

Costamagna²

2002

Dig Dis

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The interventional management of esophageal strictures remains, to date, an important clinical challenge. Stenting is probably the best palliation modality in patients with incurable esophagogastric carcinoma. Conversely, the use of esophageal stents is still relatively uncommon for the treatment of refractory benign strictures. In the last few years, several new stents have become available as a result of significant advances that have been made in terms of design and materials. This review focuses on the endoscopic use of esophageal stents in malignant and benign esophageal strictures, revisiting the different types of expandable stents presently available, the techniques, the results, and the complications of stent insertion and giving some practical advices. Future developments in the field of esophageal stenting are also discussed.

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Palliative Treatment of Inoperable Malignant Esophageal Strictures With Conically Shaped Covered Self-Expanding Stents

Abstract: Flamingo stents provide an effective and safe choice of palliative therapy in inoperable malignant esophagogastric strictures.

Cited by 5 publications

References 22 publications

Fluoroscopically guided insertion of self-expandable metal esophageal stents for palliative treatment of patients with malignant stenosis of esophagus and cardia: comparison of uncovered and covered stent types

Fluoroscopically guided insertion of self-expandable metal esophageal stents for palliative treatment of patients with malignant stenosis of esophagus and cardia: comparison of uncovered and covered stent types

Treatment of Oesophago-Gastric Tumours

Stenting in Esophageal Strictures

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