Digestive diseases and sciences · 2017
Efficacy and Safety of Fully Covered Self-Expanding Metal Stents for Malignant Esophageal Obstruction.
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So Hoonsub, Ahn Ji Yong, Han Seungbong, Jung Kyoungwon, Na Hee Kyong, Lee Jeong Hoon, Jeong Kee Wook, Kim Do Hoon, Choi Kee Don, Song Ho June, Lee Gin Hyug, Jung Hwoon-Yong
Аннотация
BACKGROUND: Malignant dysphagia can result in poor nutritional status with severe weight loss. Rapid relief from dysphagia can be achieved with esophageal self-expanding metal stents (SEMSs), a minimally invasive method. In this study, we evaluated the usefulness of SEMSs for malignant dysphagia.
METHODS: Between 2012 and 2015, 119 patients with malignant dysphagia underwent esophageal SEMS insertion with endoscopic assistance. Their demographics and clinical outcomes were collected. Factors associated with stent-related complications and patient survival were evaluated. All data were retrospectively analyzed.
RESULTS: The mean age of the 119 patients was 64.9 ± 11.6 years, and 25 (21%) were female. Seventy-five patients (63.0%) had squamous carcinoma, majority of which were located in the lower thoracic esophagus (n = 42), followed by middle thoracic esophagus (n = 19) and upper esophagus (n = 10). Eighty patients (67.2%) underwent SEMS insertion at diagnosis. Technical and clinical success rates were 99.2 and 89.9%, respectively. Complications occurred in 47 patients (39.5%); the most common complication was migration (36.3%), followed by pain and obstruction. The median stent patency time was 145 days (95% confidence interval 55.19-234.81 days). Gastric cancer (odds ratio 3.51, 95% confidence interval 1.21-10.15; p = 0.021) and a 20-mm-wide stent (odds ratio 2.922, 95% confidence interval 1.237-6.904; p = 0.015) were risk factors for complications.
CONCLUSIONS: SEMSs are effective in palliation of malignant dysphagia. However, stent-related complications should be borne in mind, particularly in patients with gastric cancer with esophageal invasion and with larger width stents.
METHODS: Between 2012 and 2015, 119 patients with malignant dysphagia underwent esophageal SEMS insertion with endoscopic assistance. Their demographics and clinical outcomes were collected. Factors associated with stent-related complications and patient survival were evaluated. All data were retrospectively analyzed.
RESULTS: The mean age of the 119 patients was 64.9 ± 11.6 years, and 25 (21%) were female. Seventy-five patients (63.0%) had squamous carcinoma, majority of which were located in the lower thoracic esophagus (n = 42), followed by middle thoracic esophagus (n = 19) and upper esophagus (n = 10). Eighty patients (67.2%) underwent SEMS insertion at diagnosis. Technical and clinical success rates were 99.2 and 89.9%, respectively. Complications occurred in 47 patients (39.5%); the most common complication was migration (36.3%), followed by pain and obstruction. The median stent patency time was 145 days (95% confidence interval 55.19-234.81 days). Gastric cancer (odds ratio 3.51, 95% confidence interval 1.21-10.15; p = 0.021) and a 20-mm-wide stent (odds ratio 2.922, 95% confidence interval 1.237-6.904; p = 0.015) were risk factors for complications.
CONCLUSIONS: SEMSs are effective in palliation of malignant dysphagia. However, stent-related complications should be borne in mind, particularly in patients with gastric cancer with esophageal invasion and with larger width stents.