Delayed Complications after Placement of Self-Expanding Stents in Malignant Esophageal Obstruction: Treatment Strategies and Survival Rate
| Autor: | Diether Ludwig, Maria R. Noftz, Rolf D. Klingenberg-Noftz, Nils Homann |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Esophageal Neoplasms Physiology medicine.medical_treatment Kaplan-Meier Estimate Recurrence medicine Humans Esophagus Survival rate Esophageal Obstruction Aged Retrospective Studies Esophageal disease business.industry Gastroenterology Stent Endoscopy Middle Aged Esophageal cancer equipment and supplies medicine.disease Dysphagia Surgery medicine.anatomical_structure Esophageal Stenosis Female Stents Esophagoscopy medicine.symptom Deglutition Disorders business Complication |
| Zdroj: | Digestive Diseases and Sciences. 53:334-340 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-007-9862-9 |
| Popis: | Placement of self-expanding metal stents is regarded as a safe and effective treatment in patients with incurable malignant esophagogastric obstruction. However, proceeding and possible benefit of re-interventions in patients with recurrent dysphagia due to delayed complications (4 weeks after stent insertion) is unclear.In 133 patients with malignant stricture of the esophagus or the esophagogastric junction 164 expandable metal stents were placed. About 89 patients were followed up until death. All tumor- or stent-related complications and consequent re-interventions were recorded.The overall incidence of delayed complications was 53.4% (71 of 133 pts.), with 34 patients (25.6%) experiencing more than one complication. Recurrent dysphagia due to tumor ingrowth (22%) or overgrowth (15%), bolus obstruction (21%), stent migration (9%), and development of esophagorespiratory fistula (9%) was successfully treated by dilatation (24%), placement of a second/third stent (27%), laser therapy (16%), and/or placement of a feeding tube (PEG, 19%). The median survival of patients with endoscopic therapy was significantly longer (222 +/- 26 days) compared to patients without re-intervention (86 +/- 14 days, P0.0001).Delayed complications after metal stent placement for malignant esophageal stricture are common, but can be treated successfully by endoscopic re-intervention in most cases. Regular interventional therapy may also improve survival. |
| Databáze: | OpenAIRE |
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