Evaluation of the Efficacy and Safety of Self-Expanding Metal Stents in Malignant Esophageal Strictures Due to Esophageal and Extraesophageal Cancers: A Retrospective Cross-Sectional Cohort Study
Ekrem Aslan1, Ayça Saltürk2, Koray Koçhan3, Serhat Özer4, Halil Şahin5, Osman Bedir6, Mevlüt Kıyak7, Emine Kanatsız8, Ali Sürmelioğlu9, Can Gönen10, Fatih Güzelbulut21Department of Internal Medicine, Istinye University Faculty of Medicine; Clinic of Gastroenterology, Liv Hospital Ulus Hospital, Istanbul, Türkiye2Department of Gastroenterology, University of Health Sciences Türkiye, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye
3Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Türkiye
4Department of Gastroenterology, Koç University Hospital, Istanbul, Türkiye
5Department of Gastroenterology, Başakşehir Çam and Sakura City Hospital, Istanbul, Türkiye
6Department of Gastroenterology, University of Health Sciences Türkiye, Evliya Çelebi Training and Research Hospital, Kütahya, Türkiye
7Department of Gastroenterology, Bakirkoy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
8Department of Gastroenterology, Konya City Hospital, Konya, Türkiye
9Department of General Surgery, University of Health Sciences Türkiye, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye
10Department of Gastroenterology, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Istanbul, Türkiye
INTRODUCTION: Malignant esophageal obstructions can lead to malnutrition, mortality, and difficulties in managing the underlying malignancy. Endoscopic stent placement is a palliative treatment method that can provide rapid improvement in dysphagia. The aim of this study is to investigate the short-term effectiveness and safety of endoscopic stent placement in patients with malignant esophageal obstructions.
METHODS: Patients who underwent endoscopic stent placement due to malignant esophageal strictures between January 2012 and January 2018 were retrospectively reviewed. Demographics, dysphagia scores, complications, and mortality data of the patients with stent placement were evaluated.
RESULTS: The mean age of the 46 patients was 67.1±13.3 years, and 19 (41.3%) were female. Endoscopic stents were placed mostly for esophageal cancer in 26 (56.5%) patients. The most common pathological diagnosis was esophageal squamous cell carcinoma (58.6%). A fully covered self-expanding metallic stent was placed in 19 (41.3%) and a partially covered one in 27 (58.7%) patients. The technical success rate was 100%. Forty (86.9%) patients began to eat soft foods 24 hours after stent placement. The most common complication was retrosternal pain (56.5%). Complications requiring endoscopic intervention occurred in 5 (10.8%) patients. Mortality occurred in 40 (87%) patients, and 11 (27.5%) survived for more than 3 months (Min-max: 125-512 days).
DISCUSSION AND CONCLUSION: Although the endoscopic placement of a self-expanding metallic stent in patients with malignant dysphagia may have the potential to cause complications, it is a reliable palliative treatment method that can be preferred due to its high technical success rate and rapid relief of dysphagia.
Manuscript Language: English