Safety of endoscopic self-expanding metallic stent placement in esophageal cancer without fluoroscopy

Abstract

Background: Esophageal self-expanding metal stent (SEMS) placement is traditionally done under fluoroscopic guidance. But few authors have shown that esophageal SEMS can be placed without fluoroscopy. The study aimed to assess the safety and success of SEMS placement in patients with carcinoma esophagus under endoscopic guidance without fluoroscopy. Methods: All patients who underwent esophageal stenting for palliation of malignant dysphagia over a 4 year period were reviewed retrospectively. Consecutive patients were identified from the endoscopy report books and inpatient admission files of medical gastroenterology department, Victoria hospital. In one hundred and ten patients with inoperable carcinoma esophagus, SEMS was placed. The procedure consisted of proximal release SEMS insertion under endoscopic guidance without the use of fluoroscopy. They were followed at one week and one month after deployment. All the complications related to the procedure were recorded. Results: 110 patients underwent endoscopic esophageal SEMS insertion for palliation of malignant dysphagia. Stent was successfully placed in all the patients. The mean age of patients was 57.38±21.21 years (range: 31 to 84 years). Dilatation of stricture before SEMS placement was needed in 33 patients (30%). No patient had esophageal perforation or stent migration. Conclusions: Esophageal stent insertion in carcinoma esophagus under endoscopic guidance without fluoroscopy is successful, safe and effective for palliation of dysphagia.