Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study

Liu, S.-Y.; Xiao, Ping; Li, T.-x.; Cao, Huicun; Mao, Aiwu; Jiang, Haoyao; Cao, Guangshao; Liu, J.; Wang, Y.-d.; Zhang, X.-S.

doi:10.1016/j.crad.2016.02.001

Cited by 9 publications

(13 citation statements)

References 22 publications

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“…In addition, massive esophageal hemorrhage is also observed following SEMS insertion in patients with malignant esophageal stricture or fistula (16,17). Prior history of radiotherapy, the presence of esophageal fistula, and concomitant airway stent insertion are major factors contributing to esophageal hemorrhage after stent insertion for patients with esophageal cancer (17,18). Thus, the role of fully covered SEMSs in the management of hemorrhage caused by esophageal cancer has not been established.…”

Section: Discussionmentioning

confidence: 99%

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Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Ren²,

Han³

2023

Front. Gastroenterol.

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ObjectiveFully covered self-expandable metallic stents (SEMSs) have been widely used as a salvage therapy for patients with esophageal variceal bleeding. However, the role of fully covered SEMSs in the management of hemorrhage caused by esophageal cancer has not yet been established. We aimed to investigate the safety and efficacy of fully covered SEMSs as a salvage therapy for esophageal cancer-related hemorrhage.MethodsFrom September 2019 to March 2022, 17 patients, who underwent the insertion of fully covered SEMS for malignant esophageal hemorrhages, were retrospectively analyzed. Chest computed tomography (CT) scans and esophagographies were performed routinely to determine the location and length of the tumor. A fully covered SEMS was implanted under fluoroscopy. Baseline demographics were retrospectively collected, that is those for sex, age, previous treatment, comorbidities, lesion type, and stent size.ResultsA total of 20 metal stents were placed in 17 patients, with a technical success rate of 100% and a hemostasis success rate of 88.2%. Stent removal was performed in three patients because of complications. No perioperative deaths were related to stent placement or removal. Five main complications (29.4%) were found after stent insertion. Stent migration and restenosis were observed in two patients (11.8%). Except for two perioperative deaths and one patient lost to follow-up, all remaining 14 patients were successfully followed up. At the end of follow-up, two patients had survived without obvious symptoms, and a total of 12 patients were dead owing to tumor progression (n = 10), severe infection (n = 1), and cerebrovascular accident (n = 1). The median overall survival was 13.8 months.ConclusionInsertion of a fully covered SEMS may be a safe and effective means of the salvage management of refractory esophageal cancer-related hemorrhage, and its use in this context may lead to the development of innovative methods for compression hemostasis. However, further study with a larger sample size and comparison with other forms of salvage therapy.

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Section: Discussionmentioning

confidence: 99%

“…In addition, it should be noted that massive esophageal hemorrhage is also observed following SEMS insertion for patients with malignant esophageal stricture or fistula (16)(17)(18). Currently, the role of fully covered SEMS in the management of hemorrhage caused by esophageal cancer is not established.…”

Section: Introductionmentioning

confidence: 99%

Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Ren²,

Han³

2023

Front. Gastroenterol.

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“…However, radiotherapy and chemoradiotherapy can cause various kinds of treatment‐related sequelae, for example, cardiac toxicities, pulmonary toxicities, and esophageal fistulas 15–17 . Furthermore, the mortality rate of patients with esophageal fistula is high 18–20 …”

Section: Discussionmentioning

confidence: 99%

Role of shrinkage in esophageal–gastric junction cancer

Leongito

Palaia

Casaretti

et al. 2023

Clinical Case Reports

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“…Bleeding after stenting of esophageal cancer is a severe complication with a high rate of mortality. Most often it develops in the first 2 wk after manipulation[ 8 , 9 ]. The main reasons include mucosal trauma caused by the free uncovered part of the stent during active esophageal peristalsis and increased pressure on the wall of the organ at the time of its expansion by the stent, leading to necrotic changes[ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The recommendations are nonsystematic in nature and one should be prepared for various scenarios, from the application of various hemostatic remedies and transfusion of blood components to angiographic methods to stop the bleeding. The unfavorable outcome of this complication can be caused by a stent itself that interferes with verification of the source of bleeding, by pathological hypervascularization of a tumor, rich blood supply of the esophagus, including from esophageal arteries stemming from the descending aorta, and by a limited amount of time available to help a patient[ 6 - 9 ].…”

Section: Introductionmentioning

confidence: 99%

Hemostasis of massive bleeding from esophageal tumor: A case report

Kashintsev¹,

Rusanov²,

Antipova³

et al. 2022

World J Gastrointest Endosc

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BACKGROUND Esophageal cancer is a common type of cancer and serious bleeding from esophageal tumors can occur in routine clinical practice. The arrest of bleeding from esophageal tumor is not a trivial task, which can sometimes require nonstandard solutions. We report a case of successful hemostasis of massive bleeding from esophageal tumor performed by a novel two-balloon catheter inserted endoscopically, with a local hemostatic treatment applied. CASE SUMMARY A 36-years old male patient with advanced esophageal cancer developed bleeding from the tumor following endoscopic stenting with a self-expanding metal stent. Due to the ineffectiveness of standard approaches, after a medical conference, the patient was treated with a novel method based on the use of a two-balloon catheter creating an isolated area in esophagus and locally dispersing hemostatic polysaccharide powder inside the isolated interior. Hemostasis was successful and subsequent endoscopic examination revealed the presence of organized clot and localized defect, which was coagulated in a planned manner. CONCLUSION The authors present a new catheter-based method of hemostasis of esophageal tumor bleeding.

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Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study

Cited by 9 publications

References 22 publications

Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Role of shrinkage in esophageal–gastric junction cancer

Hemostasis of massive bleeding from esophageal tumor: A case report

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