title: [Palliative management of malignant oesophageal strictures with endoprosthesis implantation -- 25 years experience].
abstract: OBJECTIVE
  The aim of this study was to analyse the feasibility of the use of oesophageal endoprosthesis based on a large series of cases.
  
  
  METHODS
  2952 malignant oesophageal strictures managed between 1984 and 2009 were analysed. While surgical intubation was carried out in 42 patients, endoscopic implantation was feasible in 1143 cases. Patients not eligible for oesophageal stenting were treated with gastrostomy in 125, percutaneous endoscopic gastrostomy in 19, catheter jejunostomy in 9 and supportive therapy in 965 cases, respectively.
  
  
  RESULTS
  Endoprosthesis could have been inserted in 61.2% of the patients. Dysphagia was terminated temporarily in 6.2% and permanently in 93.5%. Complications were detected in 23.7% of the cases, which included stent migration, perforation, bleeding, airway obstruction, early unexpected death, aspiration, stent obstruction, tumor overgrowth, oesophago-respiratory fistula formation and neoformation, and reflux. Complications were treated endoscopically primarily (69.2%). Lethal complication rate was 2.1% (27 cases). Furthermore, complication rate of patients who underwent surgical stent insertion was 21.9%. Mean survival of patients with oesophageal intubation was 5.4 months, with nutritional support via gastrostomy, percutaneous endoscopic gastrostomy or jejunostomy 3.6 months and with supportive therapy alone 3.2 months.
  
  
  CONCLUSIONS
  Oesophageal endoprosthesis insertion is an effective method for the palliative management of malignant oesophageal strictures. Stent implantation improves survival as well as quality of life. Methods used for nutritional support decreases hungriness but do not influence survival.
authors.affiliation: Semmelweis Egyetem I. sz. Sebészeti Klinika, Budapest. balazsdr@gmail.com
authors.forename: Akos
authors.initials: A
authors.lastname: Balázs
authors.forename: Péter
authors.initials: P
authors.lastname: Kokas
authors.forename: Péter
authors.initials: P
authors.lastname: Lukovich
authors.forename: Péter
authors.initials: P
authors.lastname: Kupcsulik
mesh_terms: D000328:Adult; D000368:Aged; D001980:Bronchi / Q000473:pathology; D003251:Constriction, Pathologic / Q000209:etiology; D004937:Esophageal Fistula / Q000209:etiology; D004938:Esophageal Neoplasms / Q000150:complications*; D004939:Esophageal Perforation / Q000209:etiology; D004940:Esophageal Stenosis / Q000209:etiology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D012086:Reoperation; D015607:Stents / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome