Document Detail


Palliation of malignant esophageal obstruction and fistulas with self expandable metallic stents.
MedLine Citation:
PMID:  21128325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas.
METHODS: SEMS were implanted in the presence of fluoroscopic guidance in patients suffering from advanced and non-resectable esophageal, cardiac and invasive lung cancer between 2002 and 2009. All procedures were performed under conscious sedation. All patients had esophagus obstruction and/or fistula. In all patients who required reintervention, recurrence of dysphagia, hemorrhage, and fistula formation were indications for further endoscopy. Patients' files were scanned retrospectively and the obtained data were analyzed using SPSS 13.0 for Windows. The χ(2) test was used for categorical data and was analysis of variance for non-categorical data. Patients' long-term survival was assessed using the Kaplan-Meier method.
RESULTS: Stents were successfully implanted in 90 patients using fluoroscopic guidance. Reasons for stent implantation in these patients were esophageal stricture (77/90, 85.5%), external pressure (8/90, 8.8%) and tracheo-esophageal fistula (5/90, 5.5%). Dysphagia scores (mean ± SD) were 3.37 ± 0.52 before and 0.90 ± 0.43 after stent implantation (P = 0.002). Intermittent, non-massive hemorrhage due to the erosion caused by the distal end of the stent in the stomach occurred in only one patient who received implementation at cardio-esophageal junction. Mean survival following stenting was 134.14 d (95% confidence interval: 94.06-174.21).
CONCLUSION: SEMS placement is safe and effective in the palliation of dysphagia in selected patients with malignant esophageal strictures.
Authors:
Ahmet Dobrucali; Erkan Caglar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  16     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  2011-03-21     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  5739-45     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Catheterization
Chi-Square Distribution
Conscious Sedation
Deglutition Disorders / etiology,  therapy
Esophageal Neoplasms / complications*,  mortality,  pathology
Esophageal Stenosis / etiology,  mortality,  therapy*
Esophagoscopy / adverse effects,  instrumentation*
Female
Foreign-Body Migration / etiology
Hemorrhage / etiology
Humans
Kaplan-Meier Estimate
Male
Metals*
Middle Aged
Neoplasm Invasiveness
Palliative Care
Prosthesis Design
Retrospective Studies
Stents*
Survival Rate
Thoracic Neoplasms / complications*,  mortality,  pathology
Time Factors
Tracheoesophageal Fistula / etiology,  mortality,  therapy*
Treatment Outcome
Turkey
Chemical
Reg. No./Substance:
0/Metals
Comments/Corrections

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