Document Detail


Malignant esophageal obstruction and esophagorespiratory fistula: palliation with a polyethylene-covered Z-stent.
MedLine Citation:
PMID:  9015055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively evaluate the clinical efficacy of polyethylene-covered metallic Z-stents in treatment of dysphagia secondary to malignant esophageal obstruction and esophagorespiratory fistula. MATERIALS AND METHODS: Thirty-five patients with dysphagia due to malignant esophageal obstruction (n = 32) and esophagorespiratory fistula (n = 3) were treated with polyethylene-covered Gianturco-Rösch Z-stents. RESULTS: Thirty-nine stents were placed in 35 patients. Stent placement was technically successful in all patients. Improvement in dysphagia was achieved in 34 of 35 patients. The average dysphagia score decreased from 3.1 (dysphagia to liquids) to 0.6 (essentially normal diet). An esophagorespiratory fistula was completely sealed in two of three patients. All 35 patients were followed up clinically at 1 day and 1 week and at 3-month intervals (range, 1 week to 18 1/2 months; mean, 4.8 months). Recurrent dysphagia or aspiration occurred in only three of 34 (9%) patients whose disease was initially palliated and was easily treated in all cases. Nine complications occurred in eight patients (23%) and included chest pain that required analgesia (n = 3), food impaction (n = 1), stent migration (n = 2), and upper gastrointestinal tract hemorrhage (n = 3). CONCLUSION: Polyethylene-covered stents are a relatively safe and effective means of long-term palliation in patients with severe malignant esophageal obstruction and esophagorespiratory fistula. These stents are easily deployed, and the rate of stent migration is relatively low.
Authors:
R R Saxon; K E Morrison; P C Lakin; B D Petersen; R E Barton; R M Katon; F S Keller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  202     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-02-27     Completed Date:  1997-02-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  349-54     Citation Subset:  AIM; IM    
Affiliation:
Dotter Interventional Institute, Oregon Health Sciences University, Portland 97201-3098, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Deglutition Disorders / etiology,  therapy
Esophageal Fistula / etiology,  radiography,  therapy*
Esophageal Neoplasms / complications,  therapy*
Esophageal Stenosis / etiology,  radiography,  therapy*
Esophagus*
Female
Fistula / etiology,  radiography,  therapy*
Humans
Male
Middle Aged
Palliative Care*
Polyethylenes
Prospective Studies
Radiography, Interventional
Respiratory Tract Neoplasms / etiology,  radiography,  therapy*
Stents* / adverse effects
Chemical
Reg. No./Substance:
0/Polyethylenes

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