The Role of Self-Expanding Metallic Endoprostheses in Esophageal Strictures

Watkinson, A.F.; Mason, Robert C.; Adam, Andreas

doi:10.1055/s-2008-1057888

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…Covered stents are superior at resisting tumour ingrowth than uncovered types but at the price of increased rates of migration. [1][2][3][4][5][6][7] This complication is particularly frequent when the stents are used for the treatment of malignant strictures in the lower third of the oesophagus. 1 The choice of available metallic stents is now large and includes the oesophageal Wallstent and Flamingo stent (Boston Scientific Inc., Watertown, Massachusetts, USA), the Ultraflex stent (Boston Scientific Inc.), the Gianturco-Rosch Z stent (William Cook, Bloomington, Indiana, USA), and the Esophacoil (Instent, Eden Prairie).…”

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confidence: 99%

A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma

Sabharwal

Hamady²,

Chui³

et al. 2003

Gut

175

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Background: Covered metallic oesophageal stents offer effective palliation of malignant oesophageal strictures. However, first generation devices were associated with a high rate of migration, particularly when used in the lower oesophagus. Aim: To compare the rate of complications and palliative effect of two newer covered metallic oesophageal stents. Patients and methods: We performed a prospective randomised study using two of these newer stent designs in the treatment of malignant lower third oesophageal tumours. Fifty three patients with dysphagia due to inoperable oesophageal carcinoma involving the lower third of the oesophagus were randomly selected to receive either a Flamingo covered Wallstent (Boston Scientific Inc., Watertown, Massachusetts, USA) or an Ultraflex covered stent (Boston Scientific Inc.). Dysphagia was scored on a five point scale, recorded before stent insertion, the day after, and at least one month later at follow up. Technical success, early and late complications (perforation, migration, severe gastro-oesophageal reflux, haematemesis, and reobstruction due to tumour overgrowth) were also recorded. Results: In both stent groups, a significant improvement in dysphagia score was seen both the next day post stenting and at late follow up (p<0.05). No significant difference was seen in the improvement in dysphagia between the two groups (p>0.1). The frequency of complications encountered in the two groups was similar. Three patients in the Ultraflex group required two stents at primary stenting. Conclusion: The two types of stent are equally effective in the palliation of dysphagia associated with lower third oesophageal malignancy and the complication rates associated with their use are comparable.

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confidence: 99%

A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma

Sabharwal

Hamady²,

Chui³

et al. 2003

Gut

175

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“…By employing self-expandable esophageal stents, we can expect the palliative relief of dysphagia resulting from stricture or obstruction of the esophagus (19,20). Presently, there exist the two following types of self-expandable stents: (a) covered and (b) uncovered.…”

Section: Discussionmentioning

confidence: 99%

“…A covered metallic stent can be used effectively in patients who have developed malignant dysphagia associated with perforation or fistula formation (20,21). Although the covered type is preferred for the prevention of tumor overgrowth, which occurs in 5%-10% of patients (19), it is so much less flexible that it shows a greater tendency toward migration than the uncovered stent (20 -22). Therefore, the disadvantage of tumor ingrowth by the uncovered stent has to be balanced against the increased rates of migration by the covered stent (13,19).…”

Section: Discussionmentioning

confidence: 99%

“…Although the covered type is preferred for the prevention of tumor overgrowth, which occurs in 5%-10% of patients (19), it is so much less flexible that it shows a greater tendency toward migration than the uncovered stent (20 -22). Therefore, the disadvantage of tumor ingrowth by the uncovered stent has to be balanced against the increased rates of migration by the covered stent (13,19). For covering metallic stents, silicone, polyethylene, and polyurethane have been used.…”

Section: Discussionmentioning

confidence: 99%

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Self-expandable covered metallic esophageal stent impregnated with beta-emitting radionuclide: an experimental study in canine esophagus

Won

Lee

Wang

et al. 2002

International Journal of Radiation Oncology*Biology*Physics

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“…Fully covered stents tend to migrate more often than uncovered ones, as has been reported for the esophagus, creating anchorage problems. 17 Therefore, we did not choose a covered metallic stent for the duodenal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Combined Use of Uncovered Duodenal and Covered Biliary Metallic Stent for Carcinoma of the Papilla of Vater

Sano

Ohara

Nakazawa

et al. 2000

Digestive Endoscopy

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We have reported successful implantation of self‐expandable metallic stents for palliative treatment in a case of an 87‐year‐old female patient with carcinoma of the papilla of Vater. She suffered from both duodenal and biliary stenoses, but refused surgical treatment. For the duodenal stenting, a self‐expandable knitted nitinol metallic stent, for esophageal use, was inserted endoscopically. For the biliary stenting, a self‐expandable metallic stent, partially polyurethane‐covered on the proximal part to prevent tumor ingrowth and overgrowth, was inserted via the percutaneous transhepatic biliary drainage route. No major complications occured during these procedures. After the two stents were inserted in an end‐to‐side fashion, she was able to eat a normal diet adequately and suffered from no abdominal symptoms and jaundice during the follow‐up period of 13 months. These stenting procedures might be less invasive and more useful than surgical treatment and provide long patency of biliary stenting and a good quality of life.

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The Role of Self-Expanding Metallic Endoprostheses in Esophageal Strictures

Cited by 5 publications

References 22 publications

A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma

A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma

Self-expandable covered metallic esophageal stent impregnated with beta-emitting radionuclide: an experimental study in canine esophagus

Combined Use of Uncovered Duodenal and Covered Biliary Metallic Stent for Carcinoma of the Papilla of Vater

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