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

Abstract

In most cases, SEMSs can be accurately and safely positioned without fluoroscopy for palliative treatment of malignant esophageal dysphagia.

Management of inoperable malignant oesophageal strictures with fully covered WallFlex® stent: A multicentre prospective study

“…Similarly to previous reports for other stents in malignant strictures [9][10][11][12][13][14][15][16][17][18][19][20], stent placement in our cohort was safe and easy in almost all cases (98.8%), with only a minority of patients (18.2%) requiring pre-stent placement dilation. The fully covered WallFlex ® stent provided a good relief of malignant dysphagia, reducing the score from a median of 3 to a median of 1 (P < 0.001) both at 14 days and 4 weeks after stent placement, in line with previous studies.…”

“…The overall dysphagia recurrence rate with SEMS, for any reason, ranges between 12% and 49% in the literature [10][11][12][13][14][15][16][17][18]23]. Even though our migration rate is slightly higher than a previous experience with the same fully covered WallFlex ® stent, which found a recurrence rate of 15% [7], it falls neatly within the rates of recurrent dysphagia reported in the literature.…”

“…Various types of self-expandable metal stents (SEMS), either fully covered or partially covered have been used for the palliation of malignant dysphagia [7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Dysphagia relief has been reported in 80-100% of patients in most of these studies.…”

“…However, a well-known and predictable drawback of the fully covered design has been an increase in the rate of migration, ranging from 20% to 39% in most studies [8,9,13,17]. Lower rates of migration, in the order of 7-12%, have been reported with some new fully covered SEMS [7,12,21,22].…”

Randomized controlled trial to investigate the effect of metal clips on early migration during stent implantation for malignant esophageal stricture

“…1 When esophageal cancers are associated with progressive dysphagia, 60%-70% of them have already lost surgical indications, 2 and stent implantation remains the primary option. [3][4][5][6][7] Esophageal stent implantation can rapidly reestablish the esophageal passage, relieve stricture symptoms, improve the nutritional status and replace esophageal reconstruction surgery, which is risky and traumatic. Therefore, esophageal stent implantation is of high clinical importance.…”