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Outcomes following oesophageal stent insertion for palliation of malignant strictures: A large single centre series
Author(s) -
Battersby Nicholas J.,
Bonney Glenn K.,
Subar Daren,
Talbot Laura,
Decadt Bart,
Lynch Niall
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22059
Subject(s) - medicine , dysphagia , stent , surgery , malignancy , complication , occlusion , radiology
Background Self‐expanding metal stents (SEMS) are an accepted intervention for malignant dysphagia. Stents vary in ease of insertion, removability, migration and occlusion rates. This series reports the complications, morbidity and mortality associated with several SEMS. Method A prospective database of patients undergoing fluoroscopic guided oesophageal stent insertion for malignancy between June 2001 and June 2009 was analysed. Patient demographics, intervention outcomes and tumour variables were correlated with stent failure and patient survival. Multivariate analysis was performed to evaluate predictors for stent failure. Results Two hundred and seventy‐three stents were deployed using nine different types of SEMS. The median Mellow–Pinkas dysphagia score significantly improved from 3 to 1 post‐stent insertion ( P < 0.001), with a technical success rate of 98%. Stent complications occurred in 95 (36%) patients [recurrent dysphagia n = 49 (19%), migration n = 24 and occlusion n = 25]. Multivariate analysis demonstrates that the covered Niti S stent fails significantly more than the double‐layered Niti S stent (OR = 4, P < 0.005). Conclusion Oesophageal stent insertion provides good palliation for malignant dysphagia, however recurrent dysphagia remains a problem. This major complication occurs more frequently with covered Niti S stents than double‐layered Niti S stents. This finding may aid the stent choice used in advanced oesophageal malignancy. J. Surg. Oncol. 2012; 105:60–65. © 2011 Wiley Periodicals, Inc.