Abstract

This is a retrospective study to evaluate the prevention of complications of metallic stent placement in patients with unresectable advanced esophageal cancer. A total of 87 patients were treated with 4 types of metal stents in the esophagus over a period of 18 years. Stent placement was technically successful. The most common prior treatment was chemoradiotherapy. There were no significant differences in the rate of patients with no complications among the prior treatments. Approximately, 30% of patients had the most common chest pain in complications. Stent placement within one month after the completion of chemoradiotherapy should be avoided for the prevention of the chest pain. There was no significant difference in the rate of patients with no complications by lesion location. The rate of no complications was higher for the Niti-S stent than the Gianturco Z-stent or Ultraflex stent. Of note, no complications were noted for the Niti-S ultrathin stent at all. Among cases of stent-related death, the most common type of complication was respiratory disorder caused by the stent that seems to be thick and hard. Therefore, the stent with thin and flexible characteristics like the Niti-S ultrathin stent will solve the various problems of esophageal stent placement.

Highlights

  • Self-expandable metallic stent (SEMS) placement is used widely for the palliative treatment of unresectable malignant esophageal stricture [1,2,3]

  • Several researchers [5,6,7,8,9] have reported that previous radiotherapy (RT) and chemotherapy are associated with an increased risk of life-threatening complications, other researchers [10, 11] have reported no relationship of life-threatening complications and these therapies

  • Stent placement was technically successful in 91/93 times (97.8%) among 87 patients

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Summary

Introduction

Self-expandable metallic stent (SEMS) placement is used widely for the palliative treatment of unresectable malignant esophageal stricture [1,2,3]. Complications were reported at rates ranging from 36%–40% [4]. Major complications such as hemorrhaging, perforation, fistula, a fever, and aspiration pneumonia have been reported to occur in 22% of cases [4]. We have placed SEMSs in patients with esophageal cancer over a period of approximately 20 years. We examined their data, retrospectively, and would like to recommend the prevention of complications based on many experiences of metallic stent placement in patients with unresectable esophageal cancer

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