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Hiran C. Fernando
Tracey L. Weigel
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James D. Luketich
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Ann Thorac Surg 2001;71:1797-1802
© 2001 The Society of Thoracic Surgeons

Original article: general thoracic

Results of expandable metal stents for malignant esophageal obstruction in 100 patients: short-term and long-term follow-up

Neil A. Christie, MDa, Percival O. Buenaventura, MDa, Hiran C. Fernando, MDa, Ninh T. Nguyen, MDa, Tracey L. Weigel, MDa, Peter F. Ferson, MDa, James D. Luketich, MDa

a Section of Thoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

Address reprint requests to Dr Luketich, Presbyterian Hospital, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213
e-mail: luketichjd{at}msx.upmc.edu

Presented at the Thirty-sixth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 31–Feb 2, 2000.

Background. Expandable metal stents palliate malignant dysphagia in most cases, but early complications and outcomes in long-term survivors have not been well described. This report summarizes our experience with expandable metal stents for malignant dysphagia.

Methods. Over a 48-month period, 127 stents were placed in 100 patients with dysphagia from esophageal cancer (93%) or lung cancer. Most had undergone prior treatment. Dysphagia scores, duration of palliation, complications, and reintervention were evaluated.

Results. Immediate improvement in dysphagia was observed in 85% of patients with no procedure-related deaths. Dysphagia score decreased from 3.3 before stent to 2.3 (p < 0.005). Average interval to reintervention was 80 days. In 40 patients surviving more than 120 days, 31 (78%) required reintervention. Major complications occurred in 3 patients receiving poststent chemoradiation (tracheoesophageal fistula, T1 vertebral body abscess, mediastinal abscess). Other complications included unsatisfactory deployment requiring immediate removal (3 patients), migration (11 patients), pain requiring removal (2 patients), food impaction (10 patients), and tumor ingrowth (37 patients).

Conclusions. Expandable metal stents offer excellent short-term palliation of malignant dysphagia. In long-term survivors, recurrent dysphagia requiring reintervention is common. In a small subset of patients receiving chemoradiation after stent placement, major complications were observed.


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Ann. Thorac. Surg. 2001 71: 1802. [Extract] [Full Text] [PDF]



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