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Maier, A; Pinter, H; Friehs, GB; Renner, H; Smolle-Jüttner, FM.
Self-expandable coated stent after intraluminal treatment of esophageal cancer: a risky procedure?
Ann Thorac Surg. 1999; 67(3):781-784 Doi: 10.1016/S0003-4975(98)01258-2
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Leading authors Med Uni Graz: Maier Alfred
Co-authors Med Uni Graz: Pinter Hans; Renner Heiko; Smolle-Juettner Freyja-Maria
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Abstract:: BACKGROUND: Stenting is a well established palliative treatment for stenotic malignant disease of the esophagus. Because of its merely mechanical potential other tumoricidal techniques are often done before stenting. METHODS: We did esophageal stenting in 11 patients (9 men and 2 women) using a self-expanding coated stent system. Three tumors were localized in the proximal, four in the middle, and four in the distal third of the esophagus. In 9 patients tumors were locally or functional nonresectable, 1 patient refused an operation, and 1 had a recurrence after esophagojejunostomy. One patient had had pretreatment by repetitive dilatation and local hyperthermia, 9 had had photodynamic therapy followed by endoluminal iridium 192 high-dose rate brachyradiotherapy, and 1 patient was admitted with esophagotracheal fistula. The interval between the last endoluminal treatment and stent insertion was between 3 and 29 days (mean, 11 days). RESULTS: In 7 patients (63.7%) no complications were observed. Four patients (36.3%) died of major complications within 1 week. Postmortem examination confirmed that the pressure of the fully expanding stent to the esophageal wall caused the rupture. CONCLUSION: The use of self-expanding coated stents in pretreated esophageal tumors is associated with a high risk of perforation due to pressure of the indwelling tube in a less resistant esophageal wall.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Aged -; Deglutition Disorders - etiology Deglutition Disorders - therapy; Esophageal Neoplasms - complications Esophageal Neoplasms - radiography Esophageal Neoplasms - therapy; Esophagus - radiography; Female -; Humans -; Male -; Middle Aged -; Palliative Care -; Stents - adverse effects