Expandable VS conventional esophageal prostheses easier insertion may not preclude subsequent stentrelated problems

Delayed Complications after Placement of Self-Expanding Stents in Malignant Esophageal Obstruction: Treatment Strategies and Survival Rate

“…Recurrent dysphagia being the leading symptom of stent dysfunction has been observed in this study and by others in as many as 50% of patients during a follow-up of 4-10 weeks [10,11]. Recanalization procedures such as laser therapy or further stent insertion, but also systemic chemotherapy and radiation seem to be of major importance to prolong stent patency [4,[6][7][8][9][10][11][12][13][14].…”

“…However, favorable factors such as ease of placement, rapid relief of dysphagia, and improvement of quality of life should be weighed against delayed complications, including tumor in-or overgrowth, food bolus obstruction, development of fistulas, and stent migration [3][4][5][6][7]. Recurrent dysphagia being the leading symptom of stent dysfunction has been observed in this study and by others in as many as 50% of patients during a follow-up of 4-10 weeks [10,11]. Recanalization procedures such as laser therapy or further stent insertion, but also systemic chemotherapy and radiation seem to be of major importance to prolong stent patency [4,[6][7][8][9][10][11][12][13][14].…”

A pragmatic randomised controlled trial of the cost-effectiveness of palliative therapies for patients with inoperable oesophageal cancer

“…188,197 Kozarek and colleagues more accurately describe their technical failures in placing 56 SEMS in 50 patients; excluding operator error there was a 20% acute placement problem rate defined as immediate migration, dislodgement and perforation. 184 It is likely that the true value for technical success lies somewhere between 80 and 100%. In a similar fashion, studies rarely define what constitutes functional success, but it appears that over 90% gain some relief from dysphagia and that the quality of swallowed diet is good, with most able to manage semisolids.…”

Endoscopic Palliation for Esophageal Cancer

“…The complications decreased to 25% with increasing experience. Kozarek et al [42] found that the efficacy of covered metal stents for sealing esophageal fistula was no different from that of the plastic stents (82 vs. 90%).…”