Self-expanding metallic stents for palliation of recurrent malignant esophageal obstruction after subtotal esophagectomy for cancer

Abstract

Local regional cancer recurrence after subtotal esophagectomy that results in dysphagia is difficult to palliate. Anastomotic recurrence or proximal esophageal stenosis due to submucosal spread of tumor or extrinsic lymph node recurrence compressing the remaining esophagus can cause dysphagia. Proximity to the cricopharyngeal sphincter is traditionally regarded as a relative contraindication to insertion of an esophageal prosthesis. Persistent foreign body sensation, pain, and possible compression of the trachea are potential shortcomings. The need for the distal end of the prosthesis to protrude into the lumen of a spacious esophageal substitute (usually the stomach) also increases the chance of stent migration. Self-expanding metallic stents have been used increasingly for palliative treatment of patients with malignant dysphagia. 1 Ell C May A. Self-expanding metal stents for palliation of stenosing tumors of the esophagus and cardia: a critical review. Endoscopy. 1997; 29: 392-398 Crossref PubMed Scopus (71) Google Scholar We report the cases of three patients with recurrence of cancer after subtotal esophagectomy whose obstruction extended near the cricopharyngeal sphincter. The use of self-expanding metallic stents for palliation is described.