TITLE

EFFICACY AND SAFETY OF PALLIATIVE STENTING FOR MALIGNANT DYSPHAGIA: A REVIEW OF 120 PATIENTS

AUTHOR(S)
Subramanian, S.; Hine, K.R.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA43
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Oesophageal carcinoma is a largely incurable disease The main aim of palliation is to restore oesophageal patency. Current oesophageal endoprostheses comprise semirigiaplastic stents and self-expandable metal stents (SEMS. In recent years, prospective randomised controlled trials have demonstrated a higher efficacy and a lower complication and mortality rate (0 v 15.8%) for SEMS v plastic stents. Aims: We reviewed our experience with the efficacy, safety and complications with stents placed for palliation of malignant dysphagia. Materials and Methods: The case notes of all patients that had a stent inserted between 1985 and 2002 were reviewed. Data including demographics, type of stent, dysphagia score prior to after implantation of stent, complications and survival were recorded on a database. Results: A total of 120 stents were implanted during the study period. We used the conventional Atkinson plastic prosthesis and four different types of SEMS: Z-stent (N=22), b-stent (N=21), Uncovered wall stent (N=5) and Choo stent (N=4). Complications were divided into immediate (<1 week) and delayed (>1 week), following stent insertion. Immediate complications for all stents in our series included chest pain - 1(0.8%), failure to deploy stent - 1 (0.8%), perforation - 8 (6.7%), stent displacement - 4 (3.3%) and death - 1 (0.8%), resulting from the procedure. Delayed complications for all stents included stent displacement - 10(8.3%), recurrent dysphagia - 10 (8.3%), food impaction - 3 (2.5%), broncho-oesophogeal fistuala formation - 4 (3.3%), bleeding - 5 (4.2%) and tumour ingrowth/ overgrowth - 4 (3.3%). Conclusions: Both immediate and delayed complication rates were higher n the plastic endoprostheses group. The complication rates are similar to previously reported series. In conclusion, SEMS are a safer and efficacious mode of palliation for oesophageal carcinoma. However, there is no added survival benefit in this group.
ACCESSION #
9747554

 

Related Articles

  • Radiotherapy versus stenting in treating malignant dysphagia. Eldeeb, Hany; El-Hadaad, Hend Ahmed // Journal of Gastrointestinal Oncology;Dec2012, Vol. 3 Issue 4, p322 

    Background: The most commonly used treatments for malignant dysphagia are stenting and radiotherapy (RT). Patients and methods: A prospective data of 91 patients with locally advanced or metastatic esophageal cancer who has been treated with either palliative RT, stent or both. Group I had RT...

  • Stents palliated, improved survival for inoperable esophageal cancer.  // Hem/Onc Today;4/10/2009, Vol. 10 Issue 7, p24 

    The article discusses a study on the role of self-expanding metal stents in reducing dysphagia and increasing survival in patients with inoperable esophageal cancer.

  • SPIRIT IV: Everolimus-eluting stent outperforms paclitaxel-eluting stent.  // Endocrine Today;Jan2011, Vol. 9 Issue 1, p38 

    This article discusses results from the SPIRIT-IV trial which showed the production of superior clinical out-comes by everolimus-eluting stents in patients without diabetes.

  • Boston Sci's Synergy trial begins to EVOLVE.  // Medical Device Daily;8/17/2010, Vol. 14 Issue 159, p9 

    The article reports on the start of patient enrollment in Boston Scientific's EVOLVE clinical trial that will investigate the safety and performance of the company's Synergy coronary stent.

  • Cervical oesophageal stent placement via a retrograde transgastric route. Inaba Y; Kamata M; Arai Y; Matsueda K; Aramaki T; Takaki H // British Journal of Radiology;Sep2004, Vol. 77 Issue 921, p787 

    During attempted oesophageal stent placement in a patient with cervical oesophageal cancer in whom swallowing of even saliva was impossible, transoral access to the cervical oesophagus was unsuccessful. Under ultrasound and fluoroscopy guidance, percutaneous gastric puncture was performed, and...

  • Self-expandable Metallic Stents for Patients with Recurrent Esophageal Carcinoma After Failure of Primary Chemoradiotherapy. Muto, Manabu; Ohtsu, Atsushi; Miyata, Yoshinori; Shioyama, Yasukazu; Boku, Narikazu; Yoshida, Shigeaki // Japanese Journal of Clinical Oncology;Jun2001, Vol. 31 Issue 6, p270 

    Examines the efficacy of self-expandable metallic stent placement for patients with esophageal carcinoma. Improvement of the oral alimentation status of the patients; Increase in the risk of life-threatening pulmonary complications; Failure in the use of chemoradiotherapy.

  • Esophageal Stenting in the Setting of Malignancy. Martinez, Juan Carlos; Puc, Matthew M.; Quiros, Roderick M. // ISRN Gastroenterology;2011, Special section p1 

    Esophageal cancer is often diagnosed at an advanced stage, with many patients found to have locoregional or metastatic disease at time of diagnosis. Because of this, cure may be unlikely, leading treatment efforts to focus more on symptom palliation and improving patient quality of life. The...

  • ENDOSCOPIC SELF-EXPANDABLE METAL STENTING FOR ADVANCED CARCINOMA OESOPHAGUS: A BETTER PALLIATIVE PROSPECTIVE. Khanna, Swagata; Khanna, Subhash // Indian Journal of Otolaryngology & Head & Neck Surgery;Jan-Mar2006, Vol. 58 Issue 1, p22 

    Endoscopic placement of metal stent is an established palliative method for advanced inoperable cases of carcinoma oesophagus. Although various types of prosthesis are available, but the recent development of self-expandable metal stents has gained popularity because of less procedure related...

  • RESOLUTE US: TLF lowered at I year with Resolute vs. Endeavor stents.  // Cardiology Today;May2011, Vol. 14 Issue 5, p12 

    This article provides the results of the RESOLUTE US trial which compared the efficacy of the Endeavor zotarolimus-eluting stent and the Resolute zotarolimus-eluting stent.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics