Survival and complications after insertion of self-expandable metal stents for malignant oesophageal stenosis.
OBJECTIVE
To report on survival and complications after insertion of self-expandable stents in patients with malignant oesophageal stenosis.


METHODS
Data were gathered retrospectively from the medical records of 92 consecutive patients in the period 1994-2003. The study comprised 68 men and 24 women (median age 72 years, range 46-93 years) with stenosis from cancer of the oesophagus (n=61), the gastric cardia (n=26) and the lung (n=5), located mainly above (n=4) or below (n=62) the carina, or at the gastro-oesophageal junction (n=26). One uncovered stent and six different covered stents were used.


RESULTS
Median and mean survival times after stenting (n=92) were 83 (range 4-1102) and 125 days, respectively. Thirty-day mortality was 19% (n=17), and 7% (n=6) survived more than one year. Survival was neither significantly influenced by division of the patients into diagnostic subgroups nor by comparison of the three most frequently used stents. One, two, three and four stents were received by 76, 11, 4 and 1 patient(s), respectively. There was no stent-related mortality, and complications were bleeding 1 (1%), stent migration 7 (8%), recurrent stenosis 8 (9%) from both tumour overgrowth (n=8) and tumour ingrowth (n=2) when using uncovered stents. Thirteen (14%) patients were re-stented because of recurrent stenosis (n=8) including fistula formation to the left main bronchus (n=2) and stent migration (n=5).


CONCLUSIONS
Use of self-expandable stents in patients with inoperable malignant oesophageal stenosis carried few complications and resulted in relatively long survival in comparison with similar studies.
Department of Gastroenterological Surgery, Ullevål University Hospital, Oslo, Norway. egil.johnson@ulleval.no
Egil
E
Johnson
Tone
T
Enden
Hans Jørgen
HJ
Noreng
Anne
A
Holck-Steen
Bjørg Eline
BE
Gjerlaug
Toril
T
Morken
Hans-Olaf
HO
Johannessen
Anders
A
Drolsum
D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000150:complications; D004940:Esophageal Stenosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D015996:Survival Rate; D016896:Treatment Outcome