title: Palliation of patients with esophagogastric neoplasms by insertion of a covered expandable modified Gianturco-Z endoprosthesis: experiences in 153 patients.
abstract: BACKGROUND
  We aimed to evaluate the short- and long-term outcomes of treatment by insertion of a covered expandable modified Gianturco-Z endoprosthesis (Song stent) in patients with esophagogastric malignancies.
  
  
  METHODS
  Consecutive patients with esophagogastric malignancies in whom a Song stent was inserted were included. Data were retrieved retrospectively. Dysphagia before and after stent placement was scored on a 5-point scale. Early (less than 30 days) and late complications (more than 30 days) were scored.
  
  
  RESULTS
  Analysis included 164 stents in 153 patients. Indications for stent placement were dysphagia and/or fistulas/perforations. The dysphagia score improved from a mean of 3.7 to 2.2 after stent placement (p < 0.0001). Fistulas/perforations sealed in 87% of cases. Early complications after stent placement occurred in 29.9% of cases. These included stent migration (4.3%), stent obstruction (6. 1%), aspiration pneumonia (4.9%), bleeding (4.3%), perforation (1. 8%), and pain (15.9%). Late complications occurred in 27.8% of cases. These included stent migration (2.6%), stent obstruction (9.6%), aspiration pneumonia (2.6%), bleeding (7.0%), perforation (0.9%), and pain (12.2%). The 30-day mortality was 26%. Death related to stent placement occurred in 3.3%.
  
  
  CONCLUSIONS
  Insertion of a Song expandable endoprosthesis in patients with esophagogastric malignancies significantly improves dysphagia, is successful in sealing fistulas/perforations, and is associated with acceptable morbidity and mortality rates.
authors.affiliation: Division of Gastroenterology and Hepatology and the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Bartelsman
authors.forename: M J
authors.initials: MJ
authors.lastname: Bruno
authors.forename: A J
authors.initials: AJ
authors.lastname: Jensema
authors.forename: J
authors.initials: J
authors.lastname: Haringsma
authors.forename: J W
authors.initials: JW
authors.lastname: Reeders
authors.forename: G N
authors.initials: GN
authors.lastname: Tytgat
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004867:Equipment Design; D004937:Esophageal Fistula / Q000209:etiology / Q000628:therapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D004939:Esophageal Perforation / Q000209:etiology / Q000628:therapy; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy; D004943:Esophagogastric Junction; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate