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 20 February 2018

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Expandable metal stents for malignant dysphagia: short- and long-term results

Expandable metal stents offer excellent short-term palliation of malignant dysphagia, however, recurrent dysphagia requiring re-intervention is common in long-term survivors, according to research in June's Annals of Thoracic Medicine.

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A team from Pittsburgh, Pennsylvania, USA, investigated the use of expandable metal stents for malignant dysphagia.

100 patients with dysphagia from esophageal cancer (93%) or lung cancer were enrolled in the trial. Over a 48-month period, 127 stents were placed in the subjects. Most individuals had undergone prior treatment.

Dysphagia scores, duration of palliation, complications, and re-intervention were evaluated.

Following stent placement, 85% of patients had instant improvement in dysphagia.
Annals of Thoracic Medicine

Immediate improvement in dysphagia was observed in 85% of patients, with no procedure-related deaths. Dysphagia score decreased from 3.3 before stent to 2.3 after the procedure.

Average interval to re-intervention was found to be 80 days. In 40 patients surviving more than 120 days, 31 (78%) required re-intervention.

The researchers found that major complications occurred in 3 patients receiving post-stent chemoradiation. These were tracheo-esophageal fistula, T1 vertebral body abscess, and mediastinal abscess.

Other complications included unsatisfactory deployment requiring immediate removal (3 patients), migration (11 patients), pain requiring removal (2 patients), food impaction (10 patients), and tumor in-growth (37 patients).

Dr Neil A. Christie, of the Section of Thoracic Surgery, University of Pittsburgh, said on behalf of his colleagues, "Expandable metal stents offer excellent short-term palliation of malignant dysphagia.

"In long-term survivors, recurrent dysphagia requiring re-intervention is common.

"In a small subset of patients receiving chemoradiation after stent placement, major complications were observed," he concluded.

Ann Thorac Surg 2001; 71: 1797-1802
14 June 2001

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