Self expandable metallic stent endoscopic insertion in esophageal cancer.
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.
Siddiqui
Ali Akbar
AA
Department of Medicine, Section of Gastroenterology, Isra University Hospital, Hyderabad. aliakbarsiddiqui@hotmail.com
Ansari
Shoaib
S
Ghouri
Muhammad Aamir
MA
Memon
Muhammad Sadik
MS
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
D008670:Metals