title: Self expandable metallic stent endoscopic insertion in esophageal cancer.
abstract: OBJECTIVE
  To determine the safety of self expandable metallic stent (SEMS) placement under endoscopic guidance without fluoroscopy.
  
  
  METHODS
  Quasi experimental study.
  
  
  METHODS
  Section of Gastroenterology and Hepatology, Departments of Medicine, Isra University Hospital and Liaquat University of Medical and Health Sciences (LUMHS), Hyderabad, from April 2006 to March 2009.
  
  
  METHODS
  In 80 patients with inoperable carcinoma of esophagus, SEMS made-up of nickel titanium alloy and mesh shaped with distal release system were placed without the use of fluoroscope under endoscopic guidance. Patients with proximal location of tumour in esophagus were excluded. They were followed at one week after deployment. All the complications were recorded. Dysphagia score was assessed before and after stent placement. Mean pre- and poststenting scores were compared using t-test.
  
  
  RESULTS
  Fluoroscopy was needed in only 2 patients. In 75 patients the stent was successfully placed with endoscope control only, without fluoroscope. Dysphagia score improved significantly from 4.26+/-1.07 before stenting to 1.02+/-0.57 later, (p<0.001). Minor complications like retrosternal pain occurred in 30 (37.5%) patients and major complications in 8 (10.0%) patients amongst which 4 (5.0%) developed upper gastrointestinal bleeding and 4 patients (5.0%) had aspiration.
  
  
  CONCLUSIONS
  Insertion of self expandable metallic stent in esophageal carcinoma without fluoroscope was safe and effective in relieving dysphagia at short term follow-up.
authors.affiliation: Department of Medicine, Section of Gastroenterology, Isra University Hospital, Hyderabad. aliakbarsiddiqui@hotmail.com
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Siddiqui
authors.forename: Shoaib
authors.initials: S
authors.lastname: Ansari
authors.forename: Muhammad Aamir
authors.initials: MA
authors.lastname: Ghouri
authors.forename: Muhammad Sadik
authors.initials: MS
authors.lastname: Memon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals