[The palliation of dysphagia secondary to esophageal-cardial carcinoma with self-expandable metal prostheses. The authors' personal experience with 92 patients].
BACKGROUND
Endoscopic insertion of a stent is an important option in the palliative management of esophageal obstruction and esophagorespiratory fistula. Plastic stents have been available for over 20 years. A new class of self-expanding metal stents for palliation of esophageal and cardial cancer is now available.


METHODS
Between September 1992 and October 1997, 92 patients underwent implantation of self-expanding metal stents for palliation of dysphagia due to inoperable esophageal or cardial cancer (65 patients) or for locally recurrent carcinoma after surgery (12 patients), laser-therapy (11 patients) or radiotherapy (4 patients).


RESULTS
Successful stent implantation was achieved in 89/92 patients (96.7%). After stent implantation the dysphagia score improved from 3.0, on average, to 0.5, on average. Early complications were observed in 4.5% and peroperative mortality was 2.1%. Late complications were observed in 25.6%, with a mortality rate of 1.1%. The mean survival time was 6.9 months.


CONCLUSIONS
Self-expanding metal stents are a new effective alternative for palliation of dysphagia due to esophageal and cardial cancers.
De Palma
G D
GD
Servizio Centralizzato di Endoscopia Digestiva Operatoria, Università degli Studi di Napoli, Federico II.
Sivero
L
L
Galloro
G
G
Siciliano
S
S
Pigna
F
F
Catanzano
C
C
D000230:Adenocarcinoma / Q000150:complications / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy*; D002299:Cardia; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
La palliazione della disfagia secondaria a carcinoma esofago-cardiale con protesi metalliche autoespandibili. Esperienza personale su 92 pazienti.