Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Tomaselli, F; Maier, A; Sankin, O; Pinter, H; Smolle, J; Smolle-Jüttner, FM.
Ultraflex stent--benefits and risks in ultimate palliation of advanced, malignant stenosis in the esophagus.
HEPATO-GASTROENTEROL. 2004; 51(58): 1021-1026.
Web of Science
PubMed
- Co-authors Med Uni Graz
- Maier Alfred
- Pinter Hans
- Sankin Oliver
- Smolle Josef
- Smolle-Juettner Freyja-Maria
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Abstract:
- BACKGROUND/AIMS: Sophisticated endoscopical palliation in end-stage malignant stenosis of the esophagus and gastroesophageal-junction must be weighed against associated morbidity and mortality. In a prospective study we investigated benefits and risks of one type of coated, self-expandable stent in ultimate palliation of esophageal neoplasms focusing on factors that might predispose patients to develop complications. METHODOLOGY: 33 men (70.2%) and 14 women (29.8%), (mean age 68.3 years, range from 38 to 90 years), suffering from nonresectable malignant stenosis of the esophagus due to advanced tumor stage and/or functional inoperability were treated by using a covered, self-expandable stent (covered ULTRAFLEX esophageal stent system, Microinvasive, Boston Scientific Corporation, Boston, MA). Stenting was indicated because of severe dysphagia for liquids and saliva in 41 (87.2%) patients, tracheoesophageal fistula in 5 (10.6%) patients and in one case of tumor bleeding (2.1%). 32 out of 47 patients had had one or other multiple treatment modalities before stenting. In 15 patients stenting was the first and only therapeutic option. RESULTS: All patients experienced an improvement of dysphagia immediately after stenting. Eight out of 47 patients (17.1%) developed major stent-associated complications: Early complications within 4 days after implantation evolved in two cases, with one patient dying from stent-induced perforation with consecutive mediastinitis and multi-organ failure. Late complications (20 to 180 days after stent implantation) occurred in 6 cases: Three esophagotracheal fistulae (two with tracheal compression) induced by stent expansion, one stent-induced bleeding and two stent dislocations. After appropriate complication management all but two patients were able to be discharged after a mean of 2.6 days. Multivariate analysis did not show any factors that might have predicted the development of major stent-associated complications. CONCLUSIONS: Implantation of the self-expandable Ultraflex-stent will efficiently palliate dysphagia, bleeding and fistulae. The 17% risk of major complications seems acceptable regarding the inherent problems of alternative treatment options, like gastrostomy, PEG, nasogastric tube or long-term parenteral feeding.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Coated Materials, Biocompatible -
- Deglutition Disorders - etiology
- Equipment Design - etiology
- Esophageal Neoplasms - complications
- Esophageal Stenosis - complications
- Esophagoscopy - complications
- Female - complications
- Fluoroscopy - complications
- Humans - complications
- Male - complications
- Middle Aged - complications
- Multivariate Analysis - complications
- Neoplasm Staging - complications
- Palliative Care - complications
- Postoperative Period - complications
- Prospective Studies - complications
- Quality of Life - complications
- Risk Assessment - complications
- Stents - adverse effects
- Survival Analysis - adverse effects
- Tomography, X-Ray Computed - adverse effects
- Treatment Outcome - adverse effects
- Find related publications in this database (Keywords)
- stent
- palliation
- esophagus