Endoprosthesis implantation at the pharyngo-esophageal level: problems, limitations and challenges.
OBJECTIVE
To present our experience with endoscopic placement of an esophageal endoprosthesis in 19 patients.


METHODS
A retrospective evaluation was made for the use of 19 stents positioned at the level of the cervical esophagus: 11 for malignant tumours (7 causing obstruction, 4 complicated by an esophago -tracheal or -cutaneous fistula), and 8 for an acquired benign tracheo-esophageal fistula due to prolonged intubation. The covered Ultraflex stent was used in all cases except two. These two patients had an esophagocutaneous fistula following laryngectomy and a Flamingo Wall stent was used.


RESULTS
Stent implantation was technically successful in all patients. Dysphagia score was improved from 3 to 2 in stenosis patients, while sealing of the fistula was achieved in all cases. The median hospital stay was 3 d for malignant tumour patients and 13.5 d for esophagocutaneous fistula patients. One Ultraflex stent and two Flamingo Wall stents were easily removed 33 d and 3 months respectively after implantation when the fistulas had totally occluded.


CONCLUSIONS
Endoprosthesis implantation for malignancy and/or fistula of malignant or benign origin at the level of the cervical esophagus is an easy, well tolerated, safe and effective procedure with no complications or mortality.
Eleftheriadis
Efthimios
E
Department of Surgery, University of Thessaloniki Medical School, Thessaloniki, Greece. elemakis@med.auth.gr
Kotzampassi
Katerina
K
D000368:Aged; D000369:Aged, 80 and over; D004937:Esophageal Fistula / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D004940:Esophageal Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000150:complications / Q000601:surgery*; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents