Self-expandable metal stents in the management of cervical oesophageal and/or hypopharyngeal strictures.
OBJECTIVE
To assess the usefulness of self-expandable metal stents in the recanalization of cervical and/or hypopharyngeal strictures.


METHODS
We report our experience in 10 patients with inoperable cervical and/or hypopharyngeal strictures treated by implantation of 11 uncovered self-expandable metal stents inserted perorally under fluoroscopic guidance. The stent was placed in the hypopharynx and cervical oesophagus in 3 patients and cervical oesophagus alone in 7. There were 8 men and 2 women, mean age 70.2 years, range 45-85 years. All patients but two had malignant stricture caused by squamous cell carcinoma, in one case there was a benign postoperative stenosis secondary to laryngectomy, and in the last patient a local recurrence from thyroid cancer.


RESULTS
Eleven stents were placed in 10 patients: technical success was achieved in 9 cases while clinical improvement was obtained in 8 cases. Seven of ten patients had a rapid improvement of dysphagia. One patient had a distal misplacement of the prosthesis, while in the other two cases stent position was very proximal and interfered with swallowing. A mean 9-month follow-up was obtained (range 3-24 months). Four patients with malignant stricture developed proliferation of neoplastic tissue after 2-5 months. The only patient treated for a benign stricture developed inside proliferation of granulation tissue after 4 months.


CONCLUSIONS
Despite several technical difficulties and a high rate of late complications, recanalization of cervical oesophageal strictures by self-expandable metal stents allowed good palliation of symptoms. Stents proved to be effective and well tolerated palliative treatment also for hypopharyngeal stenoses.
Profili
S
S
Department of Radiology, University of Sassari, Sassari, Italy.
Meloni
G B
GB
Feo
C F
CF
Pischedda
A
A
Bozzo
C
C
Ginesu
G C
GC
Canalis
G C
GC
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000000981:diagnostic imaging; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007013:Hypopharynx; D008297:Male; D008875:Middle Aged; D009333:Neck; D010166:Palliative Care / Q000379:methods*; D010608:Pharyngeal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods; D015607:Stents