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Self-expanding metal stents in palliation of malignant dysphagia: outcome of 124 Egyptian patients

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Abstract

Most cases of esophageal carcinoma are inoperable at presentation. Currently, the best method for palliation of malignant dysphagia, with or without esophago-respiratory fistula, is an insertion of esophageal self-expanding metal stents (SEMS) across the malignant esophageal stricture. Herein we present our experience in the use of SEMS in palliation of patients with malignant dysphagia and/or ERF. The study included 124 patients (79 males and 45 females) with advanced esophageal malignancy. The mean age was 54 (43–87) years. Nine patients had malignant ERF. All patients were subjected to SEMS insertion under both endoscopic and fluoroscopic guidance. SEMS insertion was successful in all patients. Nine patients had two stents. Median dysphagia score improved from 3.5 to 1.2. ERF was sealed in eight out of the nine patients. Complications related to stent implementation were reported in 41 patients. In conclusion, insertion of the SEMS is a reliable, effective, simple and safe method for palliation of malignant dysphagia with or without ERF.

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References

  1. Mason RC (2008) Esophageal diseases. In: Michael Gleeson (ed) Scott-Brown’s Otorhinolaryngology, head and neck surgery (Chap 156), 7th edn. vol IV. Hodder Arnold publisher, pp 2062–2073

  2. Knyrim K, Wagner HJ, Bethge N (1993) A controlled trial of an expansile metal stent for palliation of esophageal obstruction due to inoperable cancer. N Engl J Med 329:1302–1307

    Article  CAS  PubMed  Google Scholar 

  3. Nelson DB, Axelrad AM, Fleischer DE, Kozarek RA, Silvis SE, Freeman ML, Benjamin SB (1997) Silicone-covered Wallstent prototypes for palliation of malignant esophageal obstruction and digestive-respiratory fistulas. Gastrointest Endosc 45:31–37

    CAS  PubMed  Google Scholar 

  4. Raijman I, Lynch P (1997) Coated expandable esophageal stents in the treatment of digestive-respiratory fistulas. Am J Gastroenterol 92:2188–2191

    CAS  PubMed  Google Scholar 

  5. Duranceau A, Jamieson GG (1984) Malignant tracheoesophageal fistula. Ann Thorac Surg 37:346–354

    CAS  PubMed  Google Scholar 

  6. Wu WC, Katon RM, Saxon RR, Barton RE, Uchida BT, Keller FS, Rösch J (1994) Silicone-covered self-expanding metallic stents for the palliation of malignant esophageal obstruction and esophagorespiratory fistulas: experience in 32 patients and a review of the literature. Gastrointest Endosc 40:22–33

    CAS  PubMed  Google Scholar 

  7. Ramirez FC, Dennert B, Zierer ST (1997) Esophageal self-expandable metallic stents: indications, practice, techniques, and complications: results of a national survey. Gastrointest Endosc 45:360–364

    Article  CAS  PubMed  Google Scholar 

  8. Raijman I, Siddique I, Ajani J (1998) Palliation of malignant dysphagia and fistulae with coated expandable metal stents: experience with 101 patients. Gastrointest Endosc 48:172–179

    Article  CAS  PubMed  Google Scholar 

  9. Shields SJ (1997) Esophageal self-expandable metallic stents. Gastrointest Endosc 45:439–442

    Article  CAS  PubMed  Google Scholar 

  10. Feins RH, Johnstone DW, Baronos ES, O’Neil SM (1996) Palliation of inoperable esophageal carcinoma with the Wallstent endoprostheses. Ann Thorac Surg 62:1603–1607

    Article  CAS  PubMed  Google Scholar 

  11. Watkinson AF, Ellul J, Entwisle K, Mason RC, Adam A (1995) Esophageal carcinoma: initial results of palliative treatment with covered self-expanding endoprostheses. Radiology 195:821–827

    CAS  PubMed  Google Scholar 

  12. Ell C, Hochberger J, May A, Fleig W, Hahn E (1994) Coated and uncoated self-expanding metal stents for malignant stenosis in the upper GI tract: preliminary clinical experiences with Wallstents. Am J Gastroenterol 89:1496–1500

    CAS  PubMed  Google Scholar 

  13. Song HY, Choi KC, Kwon HC, Yang DH, Cho BH, Lee ST (1992) Esophageal strictures: treatment with a new design of modified Gianturco stent. Radiology 184:729–734

    CAS  PubMed  Google Scholar 

  14. Vermeijden JR, Bartelsman JM, Fockens P, Meijer RCA, Tytgat GNJ (1995) Self-expanding metal stents for palliation of esophageal malignancies. Gastrointest Endosc 41:58–63

    Article  CAS  PubMed  Google Scholar 

  15. Alfred M, Hans P, Gerhard BF, Heiko R, Freyja MSJ (1999) Self-expandable coated stent after intraluminal treatment of esophageal cancer: a risky procedure? Ann Thorac Surg 67:781–784

    Article  Google Scholar 

  16. Mellow MH, Pinkas H (1985) Endoscopic laser therapy for malignancies affecting the esophagus and gastroesophageal junction: analysis of technical and functional efficacy. Arch Intern Med 145:1443–1446

    Article  CAS  PubMed  Google Scholar 

  17. Botterweck AA, Schouten LJ, Volovics A (2004) Trends in incidence of adenocarcinoma of the esophagus and gastric cardia in ten European countries. Int J Epidemiol 29:645–654

    Article  Google Scholar 

  18. Stemerman DH, Caroline DF, Dabezies M, Mercader VP, Krevsky B, Gatenby RA (1997) Non-expandable silicone esophageal stents for treatment of malignant tracheoesophageal fistulas: complications and radiographic appearances. Abdom Imaging 22:14–19

    Article  CAS  PubMed  Google Scholar 

  19. Buess G, Schellong H, Kometz B, Grübner R, Junginger TH (1988) A modified prothesis for the treatment of malignant esophagotracheal fistula. Cancer 61:1679–1684

    Article  CAS  PubMed  Google Scholar 

  20. Cusumano A, Segalin A (1992) Push through intubation: effective palliation in 409 patients with cancer of the esophagus and cardia. Ann Thorac Surg 53:1010–1014

    Article  CAS  PubMed  Google Scholar 

  21. Kratz JM, Reed CE, Crawford FA (1989) A comparison of endoesophageal tubes. J Thorac Cardiovasc Surg 97:19–23

    CAS  PubMed  Google Scholar 

  22. Tomaselli F, Maier A, Sankin O, Woltsche M, Pinter H, Freyja MSJ (2001) Successful endoscopic sealing of malignant esophageotracheal fistulae by using a covered self-expandable stenting system. Eur J Cardiothorac Surg 20:734–738

    Article  CAS  PubMed  Google Scholar 

  23. Watkinson AF, Ellul J, Entwisle K, Farrugia M, Mason R, Adam A (1995) Plastic-covered metallic endoprostheses in the management of esophageal perforation in patients with esophageal carcinoma. Clin Radiol 50:304–309

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Mansoura University Hospital, Mansoura University, Mansoura, Egypt

    Asser Abdel Raouf Elsharkawy

  2. Gastroenterology Center, Mansoura University, Mansoura, Egypt

    A. A. El-Geidie

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  1. Asser Abdel Raouf Elsharkawy
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  2. A. A. El-Geidie
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Correspondence to Asser Abdel Raouf Elsharkawy.

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Elsharkawy, A.A.R., El-Geidie, A.A. Self-expanding metal stents in palliation of malignant dysphagia: outcome of 124 Egyptian patients. Eur Arch Otorhinolaryngol 267, 1123–1127 (2010). https://doi.org/10.1007/s00405-009-1198-y

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  • DOI: https://doi.org/10.1007/s00405-009-1198-y

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