Atkinson tubes are a good cost-effective means of palliating inoperable oesophageal malignant strictures: an eight-year experience.

Abstract

To determine how many oesophageal and oesophago-gastric malignancies could be successfully intubated endoscopically with an Atkinson tube, and how often a metal mesh tube would be required instead. A consecutive series of 125 patients underwent endoscopy and intubation. A total of 142 Atkinson tubes were inserted into 122 patients, and four metal mesh stents were put into three patients. The median hospital stay was 3 days, and 28 patients were treated as day cases. Atkinson tube insertion failed in only one patient. There were eight oesophageal perforations (5.6%); the procedure-related mortality was 4%. Three patients required a metal mesh stent, as dilatation proved difficult because of prior radiotherapy in two and prior surgery in one. Atkinson tubes are the stents of choice for inoperable oesophageal tumours because of low complication rates and cost efficiency. In 20% of patients, day case insertion was successful. Metal mesh stents should be reserved for those patients with tight post-radiotherapy or post-surgical strictures when dilatation is difficult.