title: Self-expandable metal stents for malignant esophageal obstruction: a comparative study between extrinsic and intrinsic compression.
abstract: Self-expandable metal stents (SEMSs) are effective for malignant esophageal obstruction, but usefulness of SEMSs in extrinsic lesions is yet to be elucidated. This study is aimed at evaluating the clinical usefulness of SEMSs in the extrinsic compression compared with intrinsic. A retrospective review was conducted for 105 patients (intrinsic, 85; extrinsic, 20) with malignant esophageal obstruction who underwent endoscopic SEMSs placement. Technical and clinical success rates were evaluated and clinical outcomes were compared between extrinsic and intrinsic group. Extrinsic group was mostly pulmonary origin. Overall technical and clinical success rate was 100% and 91%, respectively, without immediate complications. Extrinsic and intrinsic group did not differ significantly in clinical success rate. The median stent patency time was 131.3 ± 85.8 days in intrinsic group while that of extrinsic was 54.6 ± 45.1 due to shorter survival after stent insertion. The 4-, 8-, and 12-week patency rates were 90.5%, 78.8%, and 64.9% respectively in intrinsic group, while stents of extrinsic group remained patent until death. Uncovered, fully covered, and double-layered stent were used evenly and the types did not influence patency in both groups. In conclusion, esophageal SEMSs can safely and effectively be used for malignant extrinsic compression as well as intrinsic.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: K
authors.initials: K
authors.lastname: Rhee
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y C
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S K
authors.initials: SK
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J C
authors.initials: JC
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J J
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Youn
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H
authors.initials: H
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D016896:Treatment Outcome
keywords: esophagus; extrinsic; malignant; obstruction; stent