A new metal stent with a controlled-release system for palliation of malignant dysphagia: a prospective, multicenter study

Boeckel, Petra G.A. van; Repici, Alessandro; Vleggaar, Frank P.; Solito, Biagio; Rando, Giacomo; Cortelezzi, C.C.; Rossi, Mauro; Pagano, Nico; Malesci, Alberto; Siersema, Peter D.

doi:10.1016/j.gie.2009.09.046

Cited by 42 publications

(29 citation statements)

References 32 publications

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“…Las prótesis no cubiertas tienen bajas tasas de migración, pero el crecimiento tumoral dentro de ésta, puede ocurrir hasta en un 50% de los casos [30][31][32][33] . Los stent cubiertos de nitinol, como el Choostent, ofrecen la ventaja de una alta flexibilidad y son potencialmente reubicables.…”

Section: Discussionunclassified

“…Los stent cubiertos de nitinol, como el Choostent, ofrecen la ventaja de una alta flexibilidad y son potencialmente reubicables. Sus desventajas incluyen una baja radio-opacidad y una probable menor fuerza radial comparada con otras prótesis 33 . La inserción es fácil, simple y segura de efectuar.…”

Section: Discussionunclassified

“…Si se compara el desempeño inicial de la prótesis Choostent obtenido en esta serie, con los presentados por otros autores con diferentes tipos de stents, se observan resultados similares en el descenso del índice de disfagia [6][7][8][9][10] (Tabla 7). Los pacientes con fístula traqueo-esofágica presentan, por lo general, una sobrevida menor a un mes sin tratamiento específico 34 y los intentos de cirugía paliativa se asocian a una alta mortalidad 35 .…”

Section: Discussionunclassified

“…La principal causa de reaparición o empeoramiento de la disfagia fue la disfunción de la prótesis, (fractura y migración). Si se excluye esta causa, la tasa de recidiva de la disfagia desciende a sólo un 20%, cifra similar a la de otros autores [6][7][8][9][10] . La tasa de fractura de la prótesis Choostent para este estudio fue de 16,7%.…”

Section: Discussionunclassified

“…La terapia con prótesis autoexpandible metálica, cumple con la mayoría de las características de un tratamiento paliativo ideal [6][7][8][9][10] . Habitualmente es posible obtener un restablecimiento inmediato de la nutrición oral y una adecuada oclusión de fístulas traqueo-esofágicas [11][12][13] .…”

Section: Introductionunclassified

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Prótesis Choostent como método de paliación de la disfagia secundaria a patología maligna

2012

Rev Chil Cir

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Use of Choostent prosthetic device for palliation of dysphagia secondary to esophageal cancer Background: Esophageal cancer causes disabling dysphagia and swallowing problems. Aim: To prospectively analyze the outcome of the insertion of a covered self-expanding metallic Choostent type prosthesis as a method of palliation of dysphagia, esophageal fistula or leak secondary to malignant disease of the esophagus or cardia. Material and Methods: A total of 30 consecutive patients aged 75 ± 8.8 years (63% males) with malignant disease of the esophagus or cardia were studied. Results: In 27 patients (90%) the stenosis was located in the esophagus, in two (6.7%) at the gastroesophageal junction and in one (3.3%) at the esophago -jejunal anastomosis due to tumor recurrence. In 24 cases (80%), the indication of the prosthesis was dysphagia, in three (10%) the presence of a tracheo-esophageal fistula and in the remaining three (10%), the suspicion of a perforation. Patients were followed until death. The prosthesis was inserted without incidents in 29 patients (96.6%). One patient had a pneumomediastinum, which evolved favorably. Dysphagia subsided in all patients. Early evolution was satisfactory in 12 patients (66.7%). The most common early complication was a transient chest pain in 3 cases (10%). Four patients (13.3%) died within 30 days post procedure. Of the remaining 26 patients, 14 (53.8%) had late complications (recurrence of dysphagia in 42% and hemorrhage in 11%). The mean interval between stent insertion and death was 169 ± 142.5 days. Conclusions: The Choostent esophageal prosthesis improves dysphagia immediately and safely. However, its use is associated with a high rate of late complications, directly related to prosthetic dysfunction.

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Section: Discussionunclassified