Abstract
QUESTIONS: 1. Which one of the following considerations is valid when placing a stent for the management of unresectable esophageal cancer? A. Uncovered stents are not at risk for tumor in growth and resultant recurrent dysphagia. B. Migration is not an issue with partially or fully covered stents. C. Major differences in efficacy and complication rates do not exist between the available brands of self-expanding metal stents (SEMS). D. SEMS are inferior to rigid plastic prostheses in the management of unresectable obstructive esophageal cancers. E. Use of SEMS is associated with higher complications than plastic stents when inserted for malignant dysphagia. 2. Which one of the following best describes complications associated with the use of SEMS in cancer of the esophagus? A. Owing to the greater than 90% rate of complications, the use of SEMS should not be considered in the management of cancer of the esophagus. B. Dysphagia from food impaction, tissue overgrowth, and stent migration occurred less frequently in patients with small-diameter stents compared with those with large-diameter stents. C. Several complications from stent placement in esophageal malignancies have been described and range from 30 to 50% in most series. D. Minor complications are rare. 3. Which one of the following regarding spontaneous or iatrogenic esophageal perforations, fistula, and disruption of anastomosis is true? A. Spontaneous or iatrogenic esophageal perforations, esophageal fistula, and disruption of esophageal anastomosis are not associated with high morbidity and mortality rates. B. The literature on stenting in these spontaneous or iatrogenic esophageal perforations includes well-designed randomized control trials that are strongly supportive of stent use. C. Successful experiences with esophageal stent placement in the management of small perforations secondary to endoscopic therapies have not been reported and should not be considered. D. The use of self-expandable stents (SEPS, SEMS) for the management of anastomotic leaks and perforations appears promising.
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