title: Treatment of malignant esophageal obstruction with silicone-coated metallic self-expanding stents.
abstract: Six patients with high-grade malignant esophageal obstruction were treated with silicone-coated metallic self-expanding esophageal stents (Z stents). Endoscopic placement of stents was well tolerated. All patients achieved excellent palliation, defined by a decrease of at least two dysphagia grades, which was sustained. Complications occurred during follow-up in four patients and included stent migration, silicone disruption with tumor ingrowth, food impaction, and perforation (discovered at autopsy) at the distal stent site. Three of the four complications were promptly treated by endoscopic or radiologic intervention. Recent modification in stent design and placement technique will hopefully reduce complications. The self-expanding stent has several theoretical advantages over the rigid plastic stent and Nd:YAG laser for palliation of obstructing esophageal malignancy.
authors.affiliation: Department of Medicine, Oregon Health Sciences University, Portland 97201-3098.
authors.forename: J
authors.initials: J
authors.lastname: Schaer
authors.forename: R M
authors.initials: RM
authors.lastname: Katon
authors.forename: K
authors.initials: K
authors.lastname: Ivancev
authors.forename: B
authors.initials: B
authors.lastname: Uchida
authors.forename: J
authors.initials: J
authors.lastname: Rösch
authors.forename: K
authors.initials: K
authors.lastname: Binmoeller
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000379:methods; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000009:adverse effects / Q000379:methods; D011859:Radiography; D012828:Silicones; D015607:Stents
chemical_list: D012828:Silicones