Insertion of expandable metallic stents in esophageal cancer without fluoroscopy is safe and effective: a 5-year experience
| Autor: | A. F. Goddard, Lucina M. Jackson, Andrew T. Cole, Emilie A. Wilkes, Jan G. Freeman |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Adenocarcinoma Malignancy Retrospective data Esophageal stent Interquartile range medicine Humans Fluoroscopy Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Palliative Care Gastroenterology Stent Middle Aged Esophageal cancer medicine.disease Dysphagia Surgery Treatment Outcome Metals Female Stents Esophagoscopy Radiology medicine.symptom Deglutition Disorders business |
| Zdroj: | Gastrointestinal Endoscopy. 65:923-929 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/j.gie.2006.11.007 |
| Popis: | Background Self-expanding metallic stent (SEMS) placement is an important method of dysphagia palliation for patients with inoperable esophageal cancer. In most institutions, it is performed with fluoroscopic guidance; however, in 2001, we described a novel, direct-vision approach to SEMS placement, which does not require fluoroscopy. Here we report an audit of our experience over the last 5 years when using this methodology. Objective To describe our 5-year experience of 98 patients in whom esophageal stents were inserted when using the direct-vision technique and compare outcomes with published series of radiography-guided stents. Design Retrospective review of single-center experience. Setting English National Health Service Cancer Centre Hospital. Patients All patients who underwent esophageal stent insertion for a primary esophageal malignancy. Interventions SEMS insertion by direct endoscopic vision. Results Ninety-eight patients underwent SEMS insertion for malignant dysphagia during the study period, 92% of which were inserted without fluoroscopy. The technique had a low complication rate, which was consistent with published fluoroscopic data, and the median survival beyond stent insertion was 100 days (interquartile range, 62, 256; range, 4-921 days). In 59 patients, no further endoscopic palliative procedure was required. Limitations Retrospective data collection. Conclusions This series confirms direct-vision SEMS placement as a safe and efficacious method of malignant dysphagia palliation, providing definitive treatment in almost two thirds of cases. |
| Databáze: | OpenAIRE |
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