:: Volume 6, Issue 4 (Winter 2006) ::
J Ardabil Univ Med Sci 2006, 6(4): 351-356 Back to browse issues page
60 Cases of Stenting in Patients with Esophageal and Cardia-Carcinoma Junction in Imam Hospital-Tabriz
Yousef Bafandeh , Davood Daghestani
Abstract:   (13958 Views)

  Background & Objectives : Patients with esophageal SCC and GEJ adenocarcinoma have a poor prognosis. The advanced stage tumor is not amenable to cure and requires palliation, specially to relief dysphagia and to improve quality of life. Esophageal stenting has been shown to be faster, and longer lasting method of palliation. Esophageal expandable stents have been available recently in IRAN. The aim of this study was to report the results of our experience to relief dysphagia by means of stents, specially plastic removable types.

  Methods: This was a prospective trial in 60 patients with strictures due to malignant esophageal and /or GEJ cancers and those who had undergone anastomotic procedure during 2001 to 2005. These patients referred to endoscopy clinic of Tabriz Immam hospital for stenting. Dysphagia was scored according to a 5-point scale before stenting, 3 days after, and later during follow-up period of a mean of 7.6±6.6 months. Barium study and endoscopy was done for evaluation of site and length of stricture, and its etiology. Strictures were dilated up to 15 mm before stenting. The data were analyzed using correlation test, Chi-sqare and T- tests.

  Results: Covered metallic Wallstent was used in 12 patients removable covered polyflex stents in 47 and double lumen metal stent in only one case. Stents were successfully deployed in all cases. Dysphagia improved significantly by all stent types compared with the presenting status, after 3 days (p<0001) and during follow up period (p<0.05). Distal displacement of stents was seen in 16 (32%) patients, all of which happened during 1-3 months after insertion. In polyflex stents, the way restored by endoscopic intervention. Tumor overgrowth at the end of stent was seen in 4(8%) of the cases. Mean period of survival was 7.6± 6.6 months. In no case was the death directly attributable to the procedure.

  Conclusions: Self-expandable plastic stents (SEPS), have favorable efficacy in palliating dysphagia. Their insertion is easy, with low risk and successful and associated with a lower rate of complications, morbidity and mortality in majority of the patients.

Keywords: Esophageal Malignancy, Esophago-Gastric Junction, Stent
Full-Text [PDF 94 kb]   (2614 Downloads)    
Type of Study: article | Subject: Special
Received: 2006/03/15 | Accepted: 2006/08/27 | Published: 2007/04/23

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Volume 6, Issue 4 (Winter 2006) Back to browse issues page