[The use of metal vascular prosthesis in the palliative treatment of neoplastic esophago-gastric stenosis].
The paper reports the authors' experience regarding the use of expandable metal prostheses designed for vascular stenoses but adapted for unoperable esophago-gastric stenoses. Their first impressions are very positive so much so that they affirm that these prostheses are close to being ideal since they are flexible and have an insertion diameter of 3 mm which does not therefore require dilatation. As a result: 1) they involve limited trauma to the patient; 2) reduce the risk of perforation to virtually zero. Moreover: 3) they can be inserted in twisted and angled stenoses and in esophaguses with difficult access due to axial deviations and restriction of the upper cervical aperture; 4) they function well even in notoriously "difficult" sections such as the cardia and esophago-jejunal anastomoses; 5) the unfastening system is easy and rapid. On the strength of these characteristics the authors suggest that these prostheses should be used in an outpatient setting, as occurred in the case of the last of the 10 patients treated, and even at a preoperative stage in preparation for resective surgery so as to preserve normal oral feeding. The structure of these prostheses renders them contraindicated for use in stenoses associated with fistulas in air paths and requires an evaluation of long-term results to verify the incidence with which the following occur: 1) tumoral growth between the mesh; 2) food obstruction; 3) hemorrhage due to compressive necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Foco
A
A
Chirurgia d'Urgenza, Università degli Studi di Torino.
Garbarini
A
A
Serenthà
U
U
Salto
C
C
Borasio
P
P
Mossetti
C
C
Ardissone
F
F
Drago
D
D
Barberis
M
M
Spinoglio
G
G
D004938:Esophageal Neoplasms / Q000150:complications; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010166:Palliative Care; D019736:Prostheses and Implants; D013514:Surgical Procedures, Operative / Q000379:methods