Treatment of malignant esophageal obstructions with covered metallic Z stents: long-term results in 52 patients.
OBJECTIVE
To prospectively evaluate the clinical efficacy of silicone-covered Gianturco-Rösch self-expandable Z (GRZ) stents in the treatment of malignant esophageal obstruction.


METHODS
GRZ stents were placed in 52 patients (39 men, 13 women) with severe dysphagia due to high-grade malignant esophageal obstruction.


RESULTS
Stent placement was technically successful, and immediate relief of dysphagia was achieved in 50 of 52 patients (96%), with long-term relief in 47 patients (90%). Fifty-one patients (98%) died during follow-up (range, 1 week to 33 months; mean, 4.3 months). Late complications were most prevalent and included stent migration (n = 5), food impaction (n = 2), chest pain (n = 2), membrane disruption with tumor ingrowth (n = 1), granulomatous reaction above the stent (n = 1), esophageal perforation with mediastinitis (n = 1), and upper gastrointestinal hemorrhage (n = 4). Twelve complications were easily managed with medical, endoscopic, or radiologic intervention. Four deaths may have been related to stent placement (early mortality rate, 7.7%).


CONCLUSIONS
GRZ stents provide relatively safe and effective long-term palliation in patients with severe, malignant esophageal obstruction.
Saxon
R R
RR
Dotter Interventional Instite L-605, Oregon Health Sciences University, Portland 97201-3098, USA.
Barton
R E
RE
Katon
R M
RM
Petersen
B D
BD
Lakin
P C
PC
Timmermans
H
H
Uchida
B
B
Keller
F S
FS
Rösch
J
J
D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000150:complications* / Q000401:mortality; D004940:Esophageal Stenosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D019736:Prostheses and Implants; D015641:Radiography, Interventional / Q000379:methods; D015607:Stents