TY - JOUR
T1 - Treatment of Malignant Esophageal Obstructions with Covered Metallic Z Stents
T2 - Long-term Results in 52 Patients
AU - Saxon, Richard R.
AU - Barton, Robert E.
AU - Katon, Ronald M.
AU - Petersen, Bryan D.
AU - Lakin, Paul C.
AU - Timmermans, Hans
AU - Uchida, Barry
AU - Keller, Frederick S.
AU - Rösch, Josef
PY - 1995/9
Y1 - 1995/9
N2 - Purpose: To prospectively evaluate the clinical efficacy of silicone-covered Gianturco-Rösch self-expandable Z (GRZ) stents in the treatment of malignant esophageal obstruction. Patients and Methods: GRZ stents were placed in 52 patients (39 men, 13 women) with severe dysphagia due to high-grade malignant esophageal obstruction. Results: Stent placement was technically successful, and immediate relief of dysphagia was achieved in 50 of 52 patients (96%), with long-term relief in 47 patients (90%). Fifty-one patients (98%) died during follow-up (range, 1 week to 33 months; mean, 4.3 months). Late complications were most prevalent and included stent migration (n = 5), food impaction (n = 2), chest pain (n = 2), membrane disruption with tumor ingrowth (n = 1), granulomatous reaction above the stent (n = 1), esophageal perforation with mediastinitis (n = 1), and upper gastrointestinal hemorrhage (n = 4). Twelve complications were easily managed with medical, endoscopic, or radiologic intervention. Four deaths may have been related to stent placement (early mortality rate, 7.7%). Conclusion: GRZ stents provide relatively safe and effective long-term palliation in patients with severe, malignant esophageal obstruction.
AB - Purpose: To prospectively evaluate the clinical efficacy of silicone-covered Gianturco-Rösch self-expandable Z (GRZ) stents in the treatment of malignant esophageal obstruction. Patients and Methods: GRZ stents were placed in 52 patients (39 men, 13 women) with severe dysphagia due to high-grade malignant esophageal obstruction. Results: Stent placement was technically successful, and immediate relief of dysphagia was achieved in 50 of 52 patients (96%), with long-term relief in 47 patients (90%). Fifty-one patients (98%) died during follow-up (range, 1 week to 33 months; mean, 4.3 months). Late complications were most prevalent and included stent migration (n = 5), food impaction (n = 2), chest pain (n = 2), membrane disruption with tumor ingrowth (n = 1), granulomatous reaction above the stent (n = 1), esophageal perforation with mediastinitis (n = 1), and upper gastrointestinal hemorrhage (n = 4). Twelve complications were easily managed with medical, endoscopic, or radiologic intervention. Four deaths may have been related to stent placement (early mortality rate, 7.7%). Conclusion: GRZ stents provide relatively safe and effective long-term palliation in patients with severe, malignant esophageal obstruction.
KW - Esophagus, grafts and prostheses, 71.1269
KW - Esophagus, neoplasms, 71.321, 71.331
KW - Esophagus, stenosis or obstruction, 71.321
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U2 - 10.1016/S1051-0443(95)71180-0
DO - 10.1016/S1051-0443(95)71180-0
M3 - Article
C2 - 8541679
AN - SCOPUS:0029364642
SN - 1051-0443
VL - 6
SP - 747
EP - 754
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 5
ER -