title: [Endoscopic stenting of malignant stenosis in the cervical esophagus].
abstract: OBJECTIVE
  to define the optimal approach for self-expanding metal stents (SEMS) installing in the cervical esophagus in cases of malignant stenosis and to select the optimal types of stents for this tumor location.
  
  
  METHODS
  From 2004 to 2013 in P.A. Herzen Moscow Cancer Research Institute in 24 patients with cervical esophagus tumor stenosis endoscopic stenting was performed. 70% of installed stents were Choo Cervical (M.I. Tech, Korea), 13%--unspecialized Choo and Hanaro stents (M.I. Tech, Korea), and 17%--Gianturco-Z stents (Wilson-Cook, Ireland). Main contraindication for cervical esophagus stenting was location of the tumor margin less than 1 cm from the upper esophageal sphincter. In 21% of cases, endoscopic stenting was performed under combined fluoro- and endoscopic guidance, in 79%-- using only endoscopic approach.
  
  
  RESULTS
  Technical success of stent placement was achieved in all patients; SEMS was installed at the previously defined level. The accuracy of stenting was not depended from the type of guidance procedure. The most intensive pain was observed in cases with "not specialized" stents with diameter of 18, 20 or 22 mm. Average pain level in such patients was 4.54 points (VAS). In the subgroup with "cervical" stents average pain intensity was not exceed 3 points. Chronic pain syndrome lasts lifelong in 17% of patients.
  
  
  CONCLUSIONS
  The procedure of SEMS positioning under endoscopic guidance with individual selection of stent type allows restoring oral nutrition in patients with severe tumor stenosis of the cervical esophagus.
authors.forename: P V
authors.initials: PV
authors.lastname: Pavlov
authors.forename: V V
authors.initials: VV
authors.lastname: Sokolov
authors.forename: S S
authors.initials: SS
authors.lastname: Pirogov
authors.forename: E S
authors.initials: ES
authors.lastname: Karpova
authors.forename: N N
authors.initials: NN
authors.lastname: Pogorelov
authors.forename: D G
authors.initials: DG
authors.lastname: Sukhin
mesh_terms: D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents