Volume 5, Issue 6, November 2017, Page: 86-89
Palliation of Neoplastic Esophageal Strictures with Metallic Stents
Neda Nozari, Department of Gastroenterology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
Received: Sep. 18, 2017;       Accepted: Sep. 28, 2017;       Published: Nov. 6, 2017
DOI: 10.11648/j.jctr.20170506.11      View  1751      Downloads  46
Abstract
Most patients with advanced esophageal neoplasm have dysphagia and suffer from cachexia and malnourishment. Supportive treatments focus on symptom palliation and improving quality of life at this time. Guidelines illustrated some indications for stent use in esophageal neoplasm such as inoperable neoplastic obstruction, presence of neoplastic fistula or perforation, tumor recurrence and contraindication for chemo-radiotherapy. Palliative stents help relieve dysphagia, manage mouth secretions, reduce aspiration risk, and maintain oral intake. Stent placement sometimes requires both endoscopic and fluoroscopic guidance. A stricture dilation is not necessary before stent placement. Success rate of SEMS placement was reported 80-100%. Complications of stents are bleeding, perforation, migration, and tumor ingrowth. Coated SEMS are the treatment of choice in the presence of neoplastic trachea-esophageal fistula. Partially covered stents are used for neoplastic stricture but their removal is sometimes difficult. The stent can be left in esophagus indefinitely for palliation in cases with progressive disease. In this article, we reviewed the recent literatures for efficacy of palliative metal stents placement in patients with esophageal neoplasm.
Keywords
Dysphagia, Esophageal Cancer, Esophageal Stent, Self Expandable Metal Stent
To cite this article
Neda Nozari, Palliation of Neoplastic Esophageal Strictures with Metallic Stents, Journal of Cancer Treatment and Research. Vol. 5, No. 6, 2017, pp. 86-89. doi: 10.11648/j.jctr.20170506.11
Copyright
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Khamaysi I, Andraous M, Suissa A, Yassin K. Self-expandable metallic stents for the palliation of malignant dysphagia: a single center experience. Cancer Research Frontiers. Vol.3, No.2, 2016, pp.277-85.
[2]
Zaidi NH, Sibiani A. Palliation of Malignant Esophageal Obstruction and Fistulas with Metallic Stents: A Tertiary Center Experience. Surgical Science. Vol.12, No.7, 2016, pp.199.
[3]
Sgourakis G, Gockel I, Radtke A, Dedemadi G, Goumas K, Mylona S, Lang H, Tsiamis A, Karaliotas C. The use of self-expanding stents in esophageal and gastroesophageal junction cancer palliation: a meta-analysis and meta-regression analysis of outcomes. Digestive diseases and sciences. Vol.3, No.55, 2016, pp.3018-30.
[4]
Paeschke A, Bojarski C, Küpferling S, Hucklenbroich T, Siegmund B, Daum S. Unintentional Long-Term Esophageal Stenting due to a Complete Response in a Patient with Stage UICC IV Adenocarcinoma of the Gastroesophageal Junction. Case reports in gastroenterology. Vol.10, No.2, 2016, pp.218-23.
[5]
Sundelöf M, Ye W, Dickman PW, Lagergren J. Improved survival in both histologic types of oesophageal cancer in Sweden. International journal of cancer. Vol.10, No.99, 2002, pp.751-4.
[6]
Pennathur A, Chang AC, McGrath KM, Steiner G, Alvelo-Rivera M, Awais O, Gooding WE, Christie NA, Gilbert S, Landreneau RJ, Luketich JD. Polyflex expandable stents in the treatment of esophageal disease: initial experience. The Annals of thoracic surgery. Vol.30, No.85, 2008, pp.1968-73.
[7]
Sihvo EI, Luostarinen ME, Salo JA. Fate of patients with adenocarcinoma of the esophagus and the esophagogastric junction: a population-based analysis. The American journal of gastroenterology. Vol.1, No.99, 2004, pp.419.
[8]
Tian D, Wen H, Fu M. Comparative study of self-expanding metal stent and intraluminal radioactive stent for inoperable esophageal squamous cell carcinoma. World journal of surgical oncology. Vol.22, No.14, 2016, pp.18.
[9]
Radecke K, Gerken G, Treichel U. Impact of a self-expanding, plastic esophageal stent on various esophageal stenoses, fistulas, and leakages: a single-center experience in 39 patients. Gastrointestinal endoscopy. Vol.30, No.61, 2005, pp.812-8.
[10]
Ramakrishnaiah VP, Malage S, Sreenath GS, Kotlapati S, Cyriac S. Palliation of Dysphagia in Carcinoma Esophagus. Clinical medicine insights. Gastroenterology. Vol.9, No.11, 2016.
[11]
Dormann AJ, Eisendrath P, Wigginghaus B, Huchzermeyer H, Devière J. Palliation of esophageal carcinoma with a new self-expanding plastic stent. Endoscopy. No.35, 2003, pp.207-11.
[12]
Philips P, North DA, Scoggins C, Schlegel M, Martin RC. Gastric-esophageal stenting for malignant dysphagia: results of prospective clinical trial evaluation of long-term gastroesophageal reflux and quality of life-related symptoms. Journal of the American College of Surgeons. Vol.31, No.221, 2015, pp.165-73.
[13]
Mariette C, Gronnier C, Duhamel A, Mabrut JY, Bail JP, Carrere N, Lefevre JH, Meunier B, Collet D, Piessen G, FREGAT Working Group–FRENCH. Self-expanding covered metallic stent as a bridge to surgery in esophageal cancer: impact on oncologic outcomes. Journal of the American College of Surgeons. Vol.31, No.220, 2015, pp.287-96.
[14]
Selinger CP, Ellul P, Smith PA, Cole NC. Oesophageal stent insertion for palliation of dysphagia in a District General Hospital: experience from a case series of 137 patients. QJM: An International Journal of Medicine. Vol.27, No.101, 2008, pp.545-8.
[15]
Katsanos K, Sabharwal T, Adam A. Stenting of the upper gastrointestinal tract: current status. Cardiovascular and interventional radiology. Vol.1, No.33, 2010, pp.690-705.
[16]
Baerlocher MO, Asch MR. Interdisciplinary Canadian guidelines on the use of metal stents in the gastrointestinal tract for oncological indications. Canadian Association of Radiologists Journal. Vol.1, No.59, 2008, pp.107. [Abstract].
[17]
Shim CS, Jung IS. Metal stents for palliation of inoperable carcinoma of the gastrointestinal tracts. Digestive Endoscopy. Vol.3, No.16, 2004, pp. s1.
[18]
Yakoub D, Fahmy R, Athanasiou T, Alijani A, Rao C, Darzi A, Hanna GB. Evidence-based choice of esophageal stent for the palliative management of malignant dysphagia. World journal of surgery. Vol.1, No.32, 2008, pp.1996.
[19]
Jain PK. Safety of endoscopic self-expanding metallic stent placement in esophageal cancer without fluoroscopy. International Surgery Journal. Vol.10, No.3, 2016, pp.1757-60.
[20]
Singh P, Singh A, Singh A, Sharma G, Bhatia PK, Grover AS. Long Term Outcome in Patients with Esophageal Stenting for Cancer Esophagus-Our Experience at a Rural Hospital of Punjab, India. Journal of clinical and diagnostic research: JCDR. Vol.10, No.12, 2016, pp. PC06.
[21]
Uesato M, Akutsu Y, Murakami K, Muto Y, Kagaya A, Nakano A, Aikawa M, Tamachi T, Arasawa T, Amagai H, Muto Y. Comparison of Efficacy of Self-Expandable Metallic Stent Placement in the Unresectable Esophageal Cancer Patients. Gastroenterology Research and Practice. 2017.
[22]
Mao A. Interventional therapy of esophageal cancer. Gastrointestinal tumors. Vol.3, No.2, 2016, pp.59-68.
[23]
Shim CS, Cho YD, Moon JH, Kim JO, Cho JY, Kim YS, Lee JS, Lee MS. Fixation of a modified covered esophageal stent: its clinical usefulness for preventing stent migration. Endoscopy. Vol.33, No.20, 2001, pp.843-8.
[24]
Balazs A, Galambos Z, Kupcsulik PK. Characteristics of esophagorespiratory fistulas resulting from esophageal cancers: a single-center study on 243 cases in a 20-year period. World journal of surgery. Vol.1, No.33, 2009, pp.994-1001.
[25]
Park JG, Jung GS, Oh KS, Park SJ. Double-layered PTFE-covered nitinol stents: experience in 32 patients with malignant esophageal strictures. Cardiovascular and interventional radiology. Vol.1, No.33, 2010, pp.772-9.
[26]
Burstow M, Kelly T, Panchani S, Khan IM, Meek D, Memon B, Memon MA. Outcome of palliative esophageal stenting for malignant dysphagia: a retrospective analysis. Diseases of the Esophagus. Vol.1, No.22, 2009, pp.519-25.
[27]
Gray RT, O'donnell ME, Scott RD, McGuigan JA, Mainie I. Self-expanding metal stent insertion for inoperable esophageal carcinoma in Belfast: an audit of outcomes and literature review. Diseases of the Esophagus. Vol.1, No.24, 2011, pp.569-74.
[28]
Johnson E, Enden T, Noreng HJ, Holck-Steen A, Gjerlaug BE, Morken T, Johannessen HO, Drolsum A. Survival and complications after insertion of self-expandable metal stents for malignant oesophageal stenosis. Scandinavian journal of gastroenterology. Vol.1, No.41, 2006, pp.252-6.
[29]
Homann N, Noftz MR, Klingenberg-Noftz RD, Ludwig D. Delayed complications after placement of self-expanding stents in malignant esophageal obstruction: treatment strategies and survival rate. Digestive diseases and sciences. Vol.1, No.53, 2008, pp.334-40.
[30]
Christie NA, Buenaventura PO, Fernando HC, Nguyen NT, Weigel TL, Ferson PF, Luketich JD. Results of expandable metal stents for malignant esophageal obstruction in 100 patients: short-term and long-term follow-up. The Annals of thoracic surgery. Vol.30, No.71, 2001, pp.1797-802.
[31]
Uitdehaag MJ, Siersema PD, Spaander MC, Vleggaar FP, Verschuur EM, Steyerberg EW, Kuipers EJ. A new fully covered stent with antimigration properties for the palliation of malignant dysphagia: a prospective cohort study. Gastrointestinal endoscopy. Vol.31, No.71, 2010, pp.600-5.
[32]
Uitdehaag MJ, van Hooft JE, Verschuur EM, Repici A, Steyerberg EW, Fockens P, Kuipers EJ, Siersema PD. A fully-covered stent (Alimaxx-E) for the palliation of malignant dysphagia: a prospective follow-up study. Gastrointestinal endoscopy. Vol.31, No.70, 2009, pp.1082-9.
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