Self expanding metal stent for palliation of advanced esophageal carcinoma

Intubation using self-expanding stents was performed in sixty patients with inoperable esophageal carcinoma at the NCI, Cairo University between January1998 and June 2001. The ages ranged from 51 to 72 years including 36 males and 24 females. Most patients had narrowing of the lumen with an average diameter less 10 mm, 38 patients had stricture with diameter 5 mm or less. Stent placement was successful in all patients. The entire procedure was done with minimal discomfort in all patients with immediate improvement of dysphagia. The early complications [within 30 days] were serious haematemesis [3.3%], migration of the stent [3.3%], transient neck pain [6.6%] and retrosternal pain [78%]. Of these, only 12 patients had persistent pain that required potent analgesics. The delayed complications were mainly esophago-gastric reflux in 44 patients [73.3%], tumor overgrowth in 33% and food impact in 6.6%. Procedure related mortality occurred in one patient [1.6%]. The patients who were referred for radiotherapy and/or chemotherapy showed improvement in the general condition before treatment. For patients treated with radiotherapy, 73% were able to continue the radical dose as prescribed. Self-expanding stents for inoperable esophageal cancer is an easy procedure with minor complications and is important in improving the general condition of the patients before radiotherapy and/or chemotherapy

Management of parapharyngeal space tumors at the national cancer institute, Egypt

The purpose of this study is to evaluate parapharyngeal space [PPS] tumors as regards clinicopathological features, preoperative assessment, different surgical approaches, perioperative complications, patterns of recurrence and the role of non-surgical treatment. This study included twenty five patients with [PPS] tumors presented to the NCI, Cairo University, from October 2001 to March 2003. The data of each patient included age, sex, presenting symptoms and signs, provisional diagnosis, preoperative investigations, operative data, histopathological examination, non-surgical treatment and state at follow up. All were collected and analyzed. This study included 12 males and 13 females. The mean age was 37.1 years. The main presenting symptom and sign was neck swelling. All patients were subjected to CT scan, while 9 patients had MRI. Nineteen patients underwent fine needle aspiration cytology [FNAC] which was conclusive in only 16 patients. Benign lesions were found in 12 patients [48%] and malignant lesions in 13 patients [52%]. Parotid gland tumors [40%] and neurogenic tumors [16%] were the commonest. Surgical excision was done in 22 cases. There was no postoperative mortality and overall postoperative morbidity was 9% [2/22]. Eight patients received postoperative radiotherapy. Three patients with lymphoma were treated with chemotherapy and two of them received involved field radiotherapy to the Waldyer's ring region. On follow up to 12-30 months, there were only one local and two distant recurrences in the malignant group. Surgery is the mainstay treatment for tumors of the [PPS]. The addition of postoperative radiotherapy in certain indications in malignant tumors of the [PPS] will improve the local control