Covered metallic stent placement in the management of cervical esophageal strictures.

Abstract

PURPOSE:

To describe the authors' experience with self-expandable covered metallic stents in 16 patients with malignant and benign cervical esophageal strictures.

MATERIALS AND METHODS:

Sixteen expandable covered metallic stents were placed with fluoroscopic guidance in 16 patients (14 men, two women; mean age, 60 years; age range, 26-75 years) with malignant and benign strictures of the cervical esophagus. The causes of strictures were ingestion of corrosive agents (n = 3), biopsy-proved squamous cell carcinoma (n = 12), and postsurgical scarring (n = 1). The mean dysphagia scores at presentation were compared with those after stent placement by using the Wilcoxon signed rank test.

RESULTS:

Stent placement was technically successful in all patients. The reduction in the mean dysphagia score after stent placement was statistically significant (P = .0327). All patients complained of mild to severe foreign body sensation, with four reporting severe pain necessitating immediate stent removal. With the exception of one patient with limited follow-up, complications requiring intervention occurred in all patients, including migration in nine patients and tissue hyperproliferation in two. Of the 12 patients with a malignant stricture of the esophagus, four patients eventually underwent gastrostomy for the placement of a feeding tube and one patient underwent surgery. All four patients with a benign cervical stricture failed to achieve long-lasting improvement with temporary stent placement.

CONCLUSIONS:

Although the placement of covered metallic stents in the cervical esophagus provides adequate initial palliation, it is associated with poor patient tolerance and a high complication rate.

• Authors: Eugene K Choi, Ho-Young Song, Jae Wook Kim, Ji Hoon Shin, Kyung Rae Kim, Jong Hoon Kim, Sung-Bae Kim, Hwoong-Yong Jung, Seung-Il Park
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 18 Issue 7 Pg. 888-95 (Jul 2007) ISSN: 1051-0443 [Print] United States
• PMID: 17609449 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Esophageal Neoplasms (complications)
• Esophageal Stenosis (diagnostic imaging, etiology, therapy)
• Female
• Fluoroscopy
• Humans
• Male
• Middle Aged
• Radiography, Interventional
• Retrospective Studies
• Statistics, Nonparametric
• Stents (adverse effects)
• Treatment Outcome