Expandable metallic stents in the management of malignant oesophageal obstruction.
BACKGROUND
Malignant oesophageal obstruction with an advanced disease presents a difficult challenge. A new class of metal stents have been developed to overcome the limitations of existing treatment modalities.


METHODS
We present our first 58 patients, who have been treated with self-expandable metallic stents, using sedation anaesthesia, with fluoroscopic and endoscopic control. Both kinds of stents, covered and uncovered, were applied.


RESULTS
There was no procedure-related mortality. The immediate relief of dysphagia was 98%. All four oesophageal fistulas were successfully sealed with covered stents. Due to stent migration, tumour overgrowth, or ingrowth, twelve (21%) of the patients needed re-intervention. Restenting or laser therapies were used against recurrent dysphagia.


CONCLUSIONS
The palliation of oesophageal malignant obstruction with metal stents is a rapid, effective, and relatively safe single treatment which can be employed as part of a multimodal treatment program.
Toikkanen
V J
VJ
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland. vesa.toikkanen@huch.fi
Nemlander
A T
AT
Rämö
O J
OJ
Salminen
J T
JT
Pekkanen
A J
AJ
Isolauri
J O
JO
Salo
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications*; D016896:Treatment Outcome