Covered metallic stent placement in the management of cervical esophageal strictures.
OBJECTIVE
To describe the authors' experience with self-expandable covered metallic stents in 16 patients with malignant and benign cervical esophageal strictures.


METHODS
Sixteen expandable covered metallic stents were placed with fluoroscopic guidance in 16 patients (14 men, two women; mean age, 60 years; age range, 26-75 years) with malignant and benign strictures of the cervical esophagus. The causes of strictures were ingestion of corrosive agents (n = 3), biopsy-proved squamous cell carcinoma (n = 12), and postsurgical scarring (n = 1). The mean dysphagia scores at presentation were compared with those after stent placement by using the Wilcoxon signed rank test.


RESULTS
Stent placement was technically successful in all patients. The reduction in the mean dysphagia score after stent placement was statistically significant (P = .0327). All patients complained of mild to severe foreign body sensation, with four reporting severe pain necessitating immediate stent removal. With the exception of one patient with limited follow-up, complications requiring intervention occurred in all patients, including migration in nine patients and tissue hyperproliferation in two. Of the 12 patients with a malignant stricture of the esophagus, four patients eventually underwent gastrostomy for the placement of a feeding tube and one patient underwent surgery. All four patients with a benign cervical stricture failed to achieve long-lasting improvement with temporary stent placement.


CONCLUSIONS
Although the placement of covered metallic stents in the cervical esophagus provides adequate initial palliation, it is associated with poor patient tolerance and a high complication rate.
Choi
Eugene K
EK
Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Korea.
Song
Ho-Young
HY
Kim
Jae Wook
JW
Shin
Ji Hoon
JH
Kim
Kyung Rae
KR
Kim
Jong Hoon
JH
Kim
Sung-Bae
SB
Jung
Hwoong-Yong
HY
Park
Seung-Il
SI
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome