Usefulness of self-expandable metal stent for malignant esophageal stricuture

Background : Most patients with rnaligrant esophageal stricture are surgically incurable at the time of presentation. The aim of this study was to determine the safety and efficacy of endoscopic expandable metal stent tor palliation of dysphagia caused by malignant stricture. Methods : From January 2000 to December 2001, thirty-two expandable metal stents (Nitis Taewoong Med Co. Korea, 6 uncovered, 12 covered, 14 double stents for antimigration. 18 mm ciameter) were placed in 28 consecutive patients with dysphagia caused by malignancy. Dysphagia score, cornplications, reintervention, survival length after s:ent placement were evaluated. Results : This study consisted of 23 men and 5 women. The patients were composed of 13 esophageal carcinomas, 11 gastro-esophageal junction cancers or cardiac cancers, 3 lung cancers, 1 breast cancer. Immediate improvement of dysphagia symptom was seen after initial stent placement in 27 Patients (96%). Dysphagia score decreased from 3.0 (0.51) to 1.06 (0.77) after stent placement. There was one death due to hemorrhage after the procedure. There was no stent rnigration. Restenting was required in 4 cases due to tumor ingrowth (1/4) and overgrowth (3/4) and average interval to restenting was 95 days. Mean survival length was 109 days. Conclusion : Expandable metal stents offer excellent rapid palliation of malianant dysphagia. In small subest of patients who received chemoradiatien before stent placement, major complications such as bleeding, perforation, were observed.