Self expandable stent implantation into the oesophagus: complications and its therapy

Szülőkategória: KUTATÁSI TÉMÁK
06. 10. 10
Módosítás: 01 december 2016

Krisztina Tari 1 , Péter Lukovich dr. 1 , Pál Bata dr. 2 , Judit Wacha dr. 1 , Péter Kupcsulik dr. 1

Magyar Gasztroenterológiai Társaság 47. Nagygyűlésre 2005. június Balatonaliga

1 st Department of Surgery, Endoscopy, Semmelweis University 1 , Budapest

Department of Diagnostic Radiology and Oncotherapy, Semmelweis University 2 , Budapest


Introduction: There are different methods for the palliative treatment of the stenosis of the oesophagus like dilatation, laser therapy and conventional pro s thesis implantation. The newest intervention is the self - expandable stent implantation which could be more convenience for the patients.

Patients and Methods: We have implant ed 7 self - expandable covered stent in 2004. The common indications were compression and dislocation of the oesophagus due to the lung tumor and its mediastinal lymp h node metastasis, esophago-airway fistula, stenosis of the anastomosis after exstirpation of the oesophagus, and stricture of the oesophagus caused by irradiation.

Results: There were no any early complications after the implantation. Three patients had swallowing difficulties 4 to 6 month after the procedure. The contrast X-ray showed foreign material in the lumen of the stent for all three patients. Endoscopic examination revealed that the mucosa of the oesophagus proliferated through the non-covered end of the stent. We removed this overgrowing tissue by endoscopic loop resection three times for the patient who suffered from stricture after irradiation. She is alive till now . Two other patients with stricture of insufficiency of the anastomosis after resection of the oesophagus and a compression of the oesophagus by the lung cancer were treated one time. All of the patients had gained normal swallowing function after the treatment. We removed the self expandable stent in an operative way for the patient with anastomosis stricture and plastic correction was successfully performed. The 3 rd patient died because of the lung cancer .

Conclusions: The self-expandable stent implantation seems not to be the most suitable solution for the patients who have predictable long life expectancy; otherwise total covered stent should be used. Because these complications could last for a long time , special attention has to be paid to the alimentation of the patients with feeding solution.