Abstract
Objective To evaluate the efficacy and safety of covered metallic stentts in the manage- ment of proximal esophageal strictures. Methods Retrievable covered self-expanding metallic stents were inserted individually in 43 patients with malignant strictures of the proximal esophagus. Main outcome meas- ures included improvement of dysphagia, sealing of fistula and complications were evaluated. Results A to- tal of 45 stents were placed in 43 patients, with a success rate of 95.6% （43/45） at the first stent place- ment attempt. The dysphagia score improved significantly from 3.3 ±0. 6 to 1.8 ±0. 9 （ P 〈 0. 001 ）, with 18 having an excellent response and 25 having a good response. Improvement rate of dysphagia was 95.6% （43/45）. Fistula sealing was achieved in 7 of 9 patients （77.8%）. Early complications included severe pain （ n = 5 ）, mediastinal emphysema （ n = 1 ）, moderate fever （ n = 9） and collapse of the proximal end of the stent （ n = 1 ）, while late complications included migration （ n = 3） and tissue overgrowth （ n = 6）. Con- clusion Retrievable covered metallic stent placement is effective and safe for the palliation of obstructive dysphagia and sealing of fistulas in malignant proximal esophageal strictures. Key words: Esophageal strictures ; Esophageal fistula; Covered metallic stents ; Individualizedtreatment
Published Version
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