A prospective trial of self-expanding metal stents in the palliation of malignant esophageal obstruction after failure of primary curative therapy

Bethge, N; Sommer, Andrea; Kleist, Detlev von; Vakil, Nimish

doi:10.1016/s0016-5107(96)70165-7

Cited by 73 publications

(33 citation statements)

References 11 publications

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“…The outcomes of esophageal stenting may be influenced by prior chemo-or radiation therapy. In three studies performed by Bethge et al [78], Kinsman et al [79], and Siersema et al [68], the incidence of devicerelated complications was found to be higher in patients who had undergone prior radiation and/or chemotherapy than in other patients. After stent insertion, dysphagia is relieved in most patients, with an improvement in the dysphagia score of at least one grade noted in 92-98% of the patients [71][72][73][74][75][76].…”

Section: Results Of Stent Insertionmentioning

confidence: 94%

Stenting in Esophageal Strictures

Petruzziello

Costamagna²

2002

Dig Dis

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The interventional management of esophageal strictures remains, to date, an important clinical challenge. Stenting is probably the best palliation modality in patients with incurable esophagogastric carcinoma. Conversely, the use of esophageal stents is still relatively uncommon for the treatment of refractory benign strictures. In the last few years, several new stents have become available as a result of significant advances that have been made in terms of design and materials. This review focuses on the endoscopic use of esophageal stents in malignant and benign esophageal strictures, revisiting the different types of expandable stents presently available, the techniques, the results, and the complications of stent insertion and giving some practical advices. Future developments in the field of esophageal stenting are also discussed.

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Section: Results Of Stent Insertionmentioning

confidence: 94%

Stenting in Esophageal Strictures

Petruzziello

Costamagna²

2002

Dig Dis

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“…It is believed that after this treatment, vasculitis and ischemia of the esophageal tissue occurs, and that the pressure exerted by the stent can produce local necrosis which can increase the rate of complications, such as migration of the stent, perforation, hemorrhage and the fistula formation 3,34,37,41 . On the other hand, stent placement with adjuvant cytoreductive therapy can ensure earlier oral food ingestion, prevent stenosis secondary to the radioactive therapy, and allow RT/CT therapy in patients with tracheo-esophageal fistula.…”

Section: Discussionmentioning

confidence: 99%

“…Like the studies of Bethge et al 3 and Kaneko et al 0 , the dysphagia was considered improved, when there was decrease of at least one degree of dysphagia, one week after the intervention.…”

Section: Methodsmentioning

confidence: 99%

Assesment of placement of the esophageal self-expandable metallic stent in esophageal cancer in patients with or without citorreduction therapy

Kamiyama

Sakai

Moura

et al. 2007

ABCD, arq. bras. cir. dig.

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BACKGROUND: Placement of self-expanding metallic esophageal stent in patients with advanced esophageal cancer offers excellent palliation of dysphagia and tracheo-esophageal fistulas. However, the safety of stent in patients undergoing radio and/or chemotherapy is controversial, in terms of the greater risk of complications in cases where these two treatments are used in conjunction. AIM: To assess the use of stent in patients with advanced cancer of the mid-thoracic esophagus, by comparing patients undergoing cytoreductive therapy with patients who have not undergone this treatment, in relation to improvement in the dysphagia, rate of complications, period of effectiveness and survival time. METHODS: Fifty seven patients were evaluated retrospectively (16 women and 41 men, with an average age 62 years) with advanced squamous cell carcinoma of the mid-thoracic esophagus who underwent placement of the Ultraflex™ self-expandable metallic coated stent, at the Gastrointestinal Endoscopy Unit of São Paulo University Medical School between October 1988 and October 2004. Out of the 57 patients, 24 patients received adjuvant cytoreductive therapy, and 33 patients were only treated with the stent placement. RESULTS: After stent placement, there was improvement in dysphagia in both groups; there were no differences in the rate of complications, such as migration, pain, fistula, obstruction and compression of the airways; the period of effectiveness was significantly higher in the group submitted to cytoreductive therapy (average 123 days compared to 63 days), as was the survival time (average of 210 days, compared with 120 days). CONCLUSIONS: Improvement in dysphagia was statistically significant in both groups, irrespective of whether the patient had undergone adjuvant cytoreductive therapy; there were no differences in the rate of complications between the two groups and both the period of effectiveness of the stent treatment and the survival time were higher in the group with adjuvant cytoreductive therapy.

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“…Placement of a self-expanding metallic stent is one of the treatment options for esophageal stenosis. However, this procedure is associated with a high incidence of complications, particularly after radiotherapy or chemotherapy [3,4]. Therefore, the esophageal stent is not used in such the patients, and esophageal bypass has been considered to be palliative treatment.…”

Section: Introductionmentioning

confidence: 99%

Esophageal bypass in two patients with a complete response after definitive chemoradiotherapy for thoracic esophageal cancer

et al. 2014

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Esophageal bypass is a palliative operation for patients with unresectable esophageal cancer and impaired oral intake. This method is recently used to treat complications such as stenosis associated with esophageal cancer or esophagorespiratory fistula after chemoradiotherapy (CRT). However, its outcome has not been evaluated. We describe the effectiveness of esophageal bypass after CRT in two patients with a complete response (CR) but marked deterioration of quality of life due to esophageal stenosis after definitive CRT. The first patient had metastases in the right recurrent nerve lymph nodes and refused to undergo radical resection. The second patient had unresectable esophageal cancer due to invasion into the right subclavian artery. Both patients responded to esophageal bypass with good oral intake and without relapse. These two cases demonstrate that esophageal bypass can be a good, lowinvasive surgical option for patients with CR but with esophageal stenosis after definitive CRT.

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A prospective trial of self-expanding metal stents in the palliation of malignant esophageal obstruction after failure of primary curative therapy

Cited by 73 publications

References 11 publications

Stenting in Esophageal Strictures

Stenting in Esophageal Strictures

Assesment of placement of the esophageal self-expandable metallic stent in esophageal cancer in patients with or without citorreduction therapy

Esophageal bypass in two patients with a complete response after definitive chemoradiotherapy for thoracic esophageal cancer

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