Malignant dysphagia: palliation with esophageal stents--long-term results in 100 patients

Radiology. 1998 May;207(2):513-8. doi: 10.1148/radiology.207.2.9577503.

Abstract

Purpose: To evaluate the long-term palliative effect of self-expanding nitinol esophageal stents in patients with malignant dysphagia.

Materials and methods: One hundred patients with severe dysphagia secondary to malignant esophageal strictures were treated with self-expanding nitinol stents. The strictures were caused by squamous carcinoma (n = 43), adenocarcinoma (n = 28), anastomotic tumor recurrence (n = 14), and mediastinal tumor (n = 15).

Results: One hundred six stents were successfully positioned in 100 patients. Attempts to insert a second, coaxial stent were unsuccessful in two patients; a second stent was placed incorrectly in another patient. Statistically significant (P < .001) reduction of dysphagia was noted after expansion of the stents. Complications consisted of incomplete expansion secondary to stent twisting (n = 4), stent migration (n = 4), tumor ingrowth (n = 17), tumor overgrowth (n = 3), food impaction (n = 5), fracture of stent wires (n = 2), benign strictures at stent edges (n = 2), tumor bleeding (n = 3), and esophagorespiratory fistula (n = 5). The primary patency rate was 75% (77 of 102 stents); the secondary patency rate was 94% (96 of 102 stents). The survival time (mean, 6.2 months; range, 0.1-47 months) varied with the diagnosis.

Conclusion: Placement of self-expanding nitinol stents is safe and has a good long-term palliative effect on dysphagia in patients with malignant esophageal strictures.

MeSH terms

  • Adenocarcinoma / complications
  • Adult
  • Aged
  • Aged, 80 and over
  • Alloys
  • Anastomosis, Surgical / adverse effects
  • Carcinoma, Squamous Cell / complications
  • Deglutition Disorders / etiology
  • Deglutition Disorders / therapy*
  • Equipment Design
  • Equipment Failure
  • Esophageal Fistula / etiology
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / therapy*
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Food / adverse effects
  • Foreign-Body Migration / etiology
  • Hemorrhage / etiology
  • Humans
  • Longitudinal Studies
  • Male
  • Mediastinal Neoplasms / complications
  • Middle Aged
  • Neoplasm Recurrence, Local / complications
  • Palliative Care*
  • Respiratory Tract Fistula / etiology
  • Stents*
  • Surface Properties
  • Survival Rate

Substances

  • Alloys
  • nitinol