An antireflux stent versus conventional stents for palliation of distal esophageal or cardia cancer: a randomized clinical study

Abstract

Antireflux stents may be used without increased risk of complications, mortality, esophageal symptoms, or reduced global quality of life. These results should encourage large-scale randomized trials that can establish potentially beneficial effects of antireflux stents.

Malignant esophageal dysphagia palliation using insertion of a covered Ultraflex stent without fluoroscopy: a prospective observational study

“…In our prospective case series, a rather prolonged survival (median survival, 202 days) was observed in contrast to other studies [4,22]. In these patients, the use of covered SEMS permitted a significant reduction in the incidence of ingrowth (3%) and the need for additional endoscopic intervention to restore patency [4].…”

“…Indeed, gastroesophageal reflux was observed primarily in patients with tumor of the lower esophagus/GEJ (18 of 21 patients with gastroesophageal reflux). Symptoms of gastroesophageal reflux are reported to occur in 5-15% of patients with standard open stents [19,23], whereas they affect up to one-third of patients who have received a stent for a malignant stricture of the GEJ, especially when they are in the supine position [22,35]. It is our policy to prescribe proton pump inhibitors for patients with SEMS placement for esophagogastric tumors, and we advise patients to sleep in an upright position and to avoid having late-night meals.…”

The Use of Self-Expanding Stents in Esophageal and Gastroesophageal Junction Cancer Palliation: A Meta-Analysis and Meta-Regression Analysis of Outcomes

“…Two studies had a score of 4 points [6,7], eight studies had scores of 3 [4,8,10,12,[14][15][16]18], five studies scored 2 [3,9,11,13,17], and one study received one point [5]. The baseline characteristics of the patients in the trials included are summarized in Table 2.…”

“…All randomized control trials (RCTs) concerning esophageal and gastroesophageal junction palliation were identified [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Studies using the conventional prosthetic tubes (Celestin or Mackler tube) were excluded since the method has fallen out of favor.…”

Clinical Outcomes and Patency of Self-expanding Metal Stents in Patients with Malignant Upper Gastrointestinal Obstruction

“…Mean or median patient survival has been reported to vary from 10 to 20 weeks in patients who underwent SEMS placement to alleviate malignant esophageal and GEJ obstructions with variable underlying malignancy [34][35][36]. However, few reports have addressed stent patency duration and factors associated with stent patency.…”