Polyflex stents for malignant oesophageal and oesophagogastric stricture: a prospective, multicentric study.
OBJECTIVE
Dysphagia is the most distressing symptom in patients with cancer-related oesophageal obstruction. Endoscopic palliation aims to restore swallowing, avoid reintervention and to reduce hospitalization. This study reports an experience with a new self-expandable plastic stent (Polyflex) in patients with unresectable oesophageal and oesophagogastric junction cancer.


METHODS
Sixty patients were prospectively collected. The cause of obstruction was oesophageal squamous cell carcinoma (44) and adenocarcinoma (eight), lung cancer (seven) and thyroid tumour (one).


RESULTS
The stent was successfully placed in 59 patients. Early minor complications occurred in 19 patients (32%), and major complications in 13 (22%). Death occurred in three patients owing to pulmonary embolism (one) and massive haemorrhage (two). Recurrent dysphagia for early stent migration was observed in seven patients. Delayed stent migration occurred in five patients and tumour overgrowth in eight patients. The mean dysphagia score of 2.8 improved to a mean score of 1.0 after stenting (P<0.001). Overall median survival time was 4.6 months.


CONCLUSIONS
Our study suggests that Polyflex stents are competitive with metal stents, with similar efficacy but lower cost. Technical improvements, however, are required to make these stents more user friendly. Large randomized clinical studies are needed to guide in the choice among the different available stents.
Conigliaro
Rita
R
Department of Digestive Endoscopy, General Hospital, Reggio Emilia, Italy.
Battaglia
Giorgio
G
Repici
Alessandro
A
De Pretis
Giovanni
G
Ghezzo
Luigi
L
Bittinger
Max
M
Messmann
Helmut
H
Demarquay
Jean-François
JF
Togni
Michele
M
Blanchi
Sabrina
S
Filiberti
Rosangela
R
Conio
Massimo
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004812:Epidemiologic Methods; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000150:complications*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004943:Esophagogastric Junction; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D010969:Plastics; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
D010969:Plastics