[Self-expanding antireflux stents for malignant esophageal stenosis - a report of three cases].
Use of a standard open stent or self-expanding metal stent for patients with malignant dysphagia is associated with a risk of gastroesophageal reflux especially when placed across the esophagogastric junction. We report 3 cases of malignant esophageal stenosis treated with a long cover-type Niti-STM stent with an antireflux mechanism. Case 1: A 87-year-old man presented with dysphagia due to esophageal cancer at the middle thoracic esophagus. Two months after surgery using a standard open stent, the dysphagia relapsed because of tissue overgrowth. Case 2: A 73-year-old woman presented with lung cancer and severe dysphagia due to enlarged mediastinal lymph nodes. Case 3: A 66-year-old man presented with dysphagia due to esophageal cancer at the lower thoracic esophagus. All 3 patients received an antireflux stent across the esophagogastric junction. In cases 1 and 2, dysphagia was relieved immediately without complications. In case 3, the patient experienced severe reflux and chest pain associated with stent placement and could not ingest any solid food. We conclude that the antireflux stent may be useful for palliation in patients with severe malignant esophageal obstruction; however, patients should be informed about the risk of failure to prevent reflux.
Dept. of Internal Medicine, Tokyo Metropolitan Health and Medical Treatment Toshima Hospital.
Akiko
A
Kusano-Kitazume
Katsunori
K
Ami
Takeshi
T
Nagahama
Mayumi
M
Kondo
Eiko
E
Okamoto
Atsushi
A
Tamura
Kentaro
K
Takagi
Junnosuke
J
Hayasaka
Ayako
A
Watanabe
Yosuke
Y
Kawai
Keiichi
K
Fujiya
Hidetoshi
H
Amagasa
Hideaki
H
Ganno
Kenichiro
K
Imai
Akira
A
Fukuda
Masayuki
M
Ando
Kuniyoshi
K
Arai
Takao
T
Shibayama
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D017809:Fatal Outcome; D005260:Female; D005764:Gastroesophageal Reflux / Q000517:prevention & control; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology; D008297:Male; D015607:Stents