İnoperabl Malign Özofagus Darlıklarının Kendiliğinden Genişleyebilen Metalik Stentlerle Palyatif Tedavisi: Tek Merkezli 155 Hastalık Deneyim

Abstract

Objective: A retrospective study was designed to investigate the success and the complication rates of different types of self-expandable metallic stents in patients with inoperable malignant esophageal strictures. Material and Methods: One hundred fifty five patients with malignant esophageal strictures received self-expandable metallic stents under fluoroscopic guidance in our clinic between the years 1994 and 2008. A total of 137 men and 18 women aged between 26- 83 years (mean age, 58.9 years) were included in the study. Stent types used include Strecker, Wallstent, covered Wallstent, Flamingo Wallstent, Choo Stent and Song Stent. Complications of different stent types and dysphagia scores of the patients were evaluated both prior to the stent placement and afterwards. Results: Stent delivery tecnique was successful in all patients. The average dysphagia score decreased from 3.1 (dysphagia to liquids) to 1.2 (dysphagia to normal solid food) providing a 1.9 improvement in the dysphagia score. In eight cases (5.2%) early complications such as malposition and early migration were detected. In 30 cases (19.4%) late complications such as ingrowth, overgrowth, coexistence of ingrowth and overgrowth, late migration, esophago-bronchial fistula and bleeding were detected. Conclusion: Placement of self-expandable metallic stents in the palliative treatment of malignant esophageal strictures is an easily applied, well-tolerated and effective method which improves the dysphagia score of the patients with low complication rates. Our results are in agreement with the literature. The selection of the ideal stent for each patient is of great importance.