Ultraflex stent--benefits and risks in ultimate palliation of advanced, malignant stenosis in the esophagus.

摘要: BACKGROUND/AIMS: Sophisticated endoscopical palliation in end-stage malignant stenosis of the esophagus and gastroesophageal-junction must be weighed against associated morbidity mortality. In a prospective study we investigated benefits risks one type coated, self-expandable stent ultimate esophageal neoplasms focusing on factors that might predispose patients to develop complications. METHODOLOGY: 33 men (70.2%) 14 women (29.8%), (mean age 68.3 years, range from 38 90 years), suffering nonresectable due advanced tumor stage and/or functional inoperability were treated by using covered, (covered ULTRAFLEX system, Microinvasive, Boston Scientific Corporation, Boston, MA). Stenting was indicated because severe dysphagia for liquids saliva 41 (87.2%) patients, tracheoesophageal fistula 5 (10.6%) case bleeding (2.1%). 32 out 47 had or other multiple treatment modalities before stenting. 15 stenting first only therapeutic option. RESULTS: All experienced an improvement immediately after Eight (17.1%) developed major stent-associated complications: Early complications within 4 days implantation evolved two cases, with patient dying stent-induced perforation consecutive mediastinitis multi-organ failure. Late (20 180 implantation) occurred 6 cases: Three esophagotracheal fistulae (two tracheal compression) induced expansion, dislocations. After appropriate complication management all but able discharged mean 2.6 days. Multivariate analysis did not show any have predicted development CONCLUSIONS: Implantation Ultraflex-stent will efficiently palliate dysphagia, fistulae. The 17% risk seems acceptable regarding inherent problems alternative options, like gastrostomy, PEG, nasogastric tube long-term parenteral feeding.