Self expanding metal stent for palliation of advanced esophageal carcinoma

ABSTRACT

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