Prospective evaluation of a new self-expanding plastic stent for inoperable esophageal strictures

被引:77
作者
Costamagna, G [1 ]
Shah, SK [1 ]
Tringali, A [1 ]
Mutignani, M [1 ]
Perri, V [1 ]
Riccioni, ME [1 ]
机构
[1] Univ Cattolica Sacro Cuore, Digest Endoscopy Unit, Dept Surg, Rome, Italy
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2003年 / 17卷 / 06期
关键词
D O I
10.1007/s00464-002-9098-x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: High stent cost is considered the major drawback of self-expanding metal stents for dysphagia palliation in patients with inoperable esophageal strictures. We report our experience with a self-expanding plastic (Poly. ex) stent, the cost of which is half that of the metal stents. Methods: Between September 1999 and April 2001, 16 dysphagic patients (15 men; mean age, 69.4 +/- 14.5 years; range, 49-100 years; mean dysphagia score, 3.31 +/- 0.6) with esophageal strictures who underwent Poly. ex stent placement (insertion device diameter, 12 14 mm; postexpansion inner stent diameter, 16-21 mm; stent length, 9, 12, and 15 cm) were studied prospectively. The strictures were caused by postsurgical recurrence of gastric/esophageal cancer at the anastomotic site in five patients, primary esophageal cancer in four patients, esophagocardia junction cancer in four patients, metastatic mediastinal lymph nodes from a primary lung cancer invading the esophagus in 1 patient, and benign peptic stricture in two elderly patients. All the patients were prospectively followed until death. Results: Stent insertion was technically successful in 12 patients (75%). Stent placement failed in four patients (25%) because of failure to pass the delivery catheter across the stricture in three patients and failure of the stent to open in one patient. Early and late stent migration occurred in two patients and 1 patient, respectively. Tumor overgrowth occurred in 1 patient. The mean dysphagia score 7 days after stent placement was 1.1 +/- 0.9. Mean survival was 100.6 +/- 71.2 days (range, 8-225 days). Conclusion: Self-expanding Polyflex stents are safe and effective for inoperable esophageal strictures and have an acceptable technical success rate. Further experience, better selection criteria, and design improvements should improve results.
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页码:891 / 895
页数:5
相关论文
共 15 条
[1]  
Bethge N, 2001, AM J GASTROENTEROL, V96, P1350
[2]  
DePalma GD, 1996, GASTROINTEST ENDOSC, V43, P478
[3]  
EARLAM R, 1980, BRIT J SURG, V67, P456
[4]   Self-expandable metal coil stents in the treatment of benign esophageal strictures refractory to conventional therapy: a case series [J].
Fiorini, A ;
Fleischer, D ;
Valero, J ;
Israeli, E ;
Wengrower, D ;
Goldin, E .
GASTROINTESTINAL ENDOSCOPY, 2000, 52 (02) :259-262
[5]  
FUEGGER R, 1990, Endoscopy, V22, P101
[6]   A CONTROLLED TRIAL OF AN EXPANSILE METAL STENT FOR PALLIATION OF ESOPHAGEAL OBSTRUCTION DUE TO INOPERABLE CANCER [J].
KNYRIM, K ;
WAGNER, HJ ;
BETHGE, N ;
KEYMLING, M ;
VAKIL, N .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 329 (18) :1302-1307
[7]   Self-expanding metal stents for palliation of malignant obstruction in the upper gastrointestinal tract - Comparative assessment of three stent types implemented in 96 implantations [J].
May, A ;
Hahn, EG ;
Ell, C .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 1996, 22 (04) :261-266
[8]  
Mokhashi M S, 1999, Gastrointest Endosc Clin N Am, V9, P413
[9]   The cost effectiveness of metal oesophageal stenting in malignant disease compared with conventional therapy [J].
Nicholson, DA ;
Haycox, A ;
Kay, CL ;
Rate, A ;
Attwood, S ;
Bancewicz, J .
CLINICAL RADIOLOGY, 1999, 54 (04) :212-215
[10]  
Schmassmann A, 1997, AM J GASTROENTEROL, V92, P400