Polyflex stents for malignant oesophageal and oesophagogastric stricture: a prospective, multicentric study

被引:58
作者
Conigliaro, Rita [2 ]
Battaglia, Giorgio [3 ]
Repici, Alessandro [4 ]
De Pretis, Giovanni [5 ]
Ghezzo, Luigi [6 ]
Bittinger, Max [8 ]
Messmann, Helmut [8 ]
Demarquay, Jean-Francois [9 ]
Togni, Michele [5 ]
Blanchi, Sabrina [1 ]
Filiberti, Rosangela [7 ]
Conio, Massimo [1 ]
机构
[1] Sanremo Hosp, Dept Gastroenterol, I-18038 San Remo, Italy
[2] Gen Hosp, Dept Digest Endoscopy, Reggio Emilia, Italy
[3] Univ Padua, Dept Med & Surg Sci, Padua, Italy
[4] Humanitas, Dept Digest Endoscopy, Rozzano, Italy
[5] Santa Chiara Hosp, Dept Gastroenterol, Trento, Italy
[6] S Croce & Carle Hosp, Dept Gastroenterol, Cuneo, Italy
[7] Natl Inst Canc Res, Genoa, Italy
[8] Dept Internal Med 1, Augsburg, Germany
[9] Univ Hosp, Dept Gastroenterol, Nice, France
关键词
cancer; dysphagia; oesophagus; plastic stent;
D O I
10.1097/MEG.0b013e328013a418
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective Dysphagia is the most distressing symptom in patients with cancer-related oesophageal obstruction. Encloscopic palliation aims to restore swallowing, avoid reintervention and to reduce hospitalization. This study reports an experience with a new self-expandable plastic stent (Polyflex) in patients with unresectable oesophageal and oesophagogastric junction cancer. Methods Sixty patients were prospectively collected. The cause of obstruction was oesophageal squamous cell carcinoma (44) and adenocarcinoma (eight), lung cancer (seven) and thyroid tumour (one). Results The stent was successfully placed in 59 patients. Early minor complications occurred in 19 patients; (32%), and major complications in 13 (22%). Death occurred in three patients owing to pulmonary embolism (one) and massive haemorrhage (two). Recurrent dysphagia for early stent migration was observed in seven patients. Delayed stent migration occurred in five patients and tumour overgrowth in eight patients. The mean dysphagia score of 2.8 improved to a mean score of 1.0 after stenting (P<0.001). Overall median survival time was 4.6 months. Conclusions Our study suggests that Polyflex stents are competitive with metal stents, with similar efficacy but lower cost. Technical improvements, however, are required to make these stents more user friendly. Large randomized clinical studies are needed to guide in the choice among the different available stents. Eur J Gastroenterol Hepatol 19:195-203 (C) 2007 Lippincott Williams & Wilkins.
引用
收藏
页码:195 / 203
页数:9
相关论文
共 47 条
[2]   Palliation of patients with esophagogastric neoplasms by insertion of a covered expandable modified Gianturco-Z endoprosthesis: experiences in 153 patients [J].
Bartelsman, JFW ;
Bruno, MJ ;
Jensema, AJ ;
Haringsma, J ;
Reeders, JWAJ ;
Tytgat, GNJ .
GASTROINTESTINAL ENDOSCOPY, 2000, 51 (02) :134-138
[3]   A prospective trial of self-expanding metal stents in the palliation of malignant esophageal obstruction after failure of primary curative therapy [J].
Bethge, N ;
Sommer, A ;
vonKleist, D ;
Vakil, N .
GASTROINTESTINAL ENDOSCOPY, 1996, 44 (03) :283-286
[4]  
Bethge N, 2001, AM J GASTROENTEROL, V96, P1350
[5]  
CHRISTIE NA, 1997, ANN THORAC SURG, V71, P1801
[6]   Prospective evaluation of a new self-expanding plastic stent for inoperable esophageal strictures [J].
Costamagna, G ;
Shah, SK ;
Tringali, A ;
Mutignani, M ;
Perri, V ;
Riccioni, ME .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2003, 17 (06) :891-895
[7]   Use of the Polyflex stent in the palliative therapy of esophageal carcinoma - Results in 14 cases and review of the literature [J].
Decker, P ;
Lippler, J ;
Decker, D ;
Hirner, A .
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 2001, 15 (12) :1444-1447
[8]  
DePalma GD, 1996, GASTROINTEST ENDOSC, V43, P478
[9]  
DEPALMA GD, 1995, AM J GASTROENTEROL, V90, P2140
[10]   Palliation of esophageal carcinoma with a new self-expanding plastic stent [J].
Dormann, AJ ;
Eisendrath, P ;
Wigginghaus, B ;
Huchzermeyer, H ;
Devière, J .
ENDOSCOPY, 2003, 35 (03) :207-211