[The palliative treatment of malignant esophageal stenosis and fistulae with self-expanding metal prostheses].
OBJECTIVE
To evaluate the efficiency of self-expanding metal stents (SES) for the palliative treatment of malignant oesophageal strictures and fistulas.


METHODS
Fifty non-operable patients with malignant oesophageal strictures and/or fistulas were treated with SES placement. All patients had dysphagia, the mean degree for the studied group being 3.36. Ten patients presented associated tumoral fistula. Uncoated SES were placed for simple stenosis cases and coated SES for cancers with associated fistulas.


RESULTS
A improvement in dysphagia was obtained in 47 patients (94%). The mean degree of dysphagia after the procedure was 1.12. In nine patients (90%) the fistula closed with resolution of the associated clinical picture. Complication were observed in six patients (12%), the perioperative mortality rate being 2%. During follow-up, twelve patients (25%) had malfunction of the stent, which was successfully treated in eight patients.


CONCLUSIONS
SES are efficient for the palliative treatment of malignant oesophageal strictures and/or fistulas, but not commonly re-interventions are necessary to maintain a long-term functionality.
Echenagusia Beida
A
A
Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid.
Simó Muerza
G
G
Camúñez Alonso
F
F
Barreiro-Meiro Sáenz-Díez
I
I
Hurtado Lalanne
M
M
Relanzón Molinero
S
S
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*; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D015641:Radiography, Interventional; D015607:Stents / Q000009:adverse effects