Esophageal self-expandable metal stent placement for the palliation of dysphagia due to lung cancer

[Technical features of esophageal stent deployment]

OBJECTIVE

To work out the optimal technique of endoscopic stenting of the esophagus (ESE) using various delivery devices (DD); to analyze immediate and long-term results of stenting depending on the type of DD.

MATERIAL AND METHODS

ESE results were studied in 83 patients. Group 1 included 41 patients with implantation of metal stents delivered on a knitted tubular casing (21 stents with proximal opening and 20 stents with distal opening). Group 2 consisted of 42 patients who underwent ESE using a DD in the form of a contracting outer shell.

RESULTS

In the 1^st group, DD «stumbling» in 6 cases (14.6%) required additional tubular hollow rigid conductor. In the 2^nd group, there was no need for additional conductor (p=0.011). Intraoperative stent repositioning after its initial installation was required in 7 cases (17.1%) of the 1^st group and 16 cases (38.1%) of the 2^nd group (p=0.033). Higher likelihood of stent repositioning was observed in distal stent opening. Technical success rate was 100% in both groups. Clinical success rate was 100% in the 1^st group and 97.6% in the 2^nd group (p>0.05). Incidence of early and long-term postoperative complications was similar (p>0.05).

CONCLUSION

ESE with various DDs is safe and effective in patients with malignant unresectable esophageal tumors and symptoms of dysphagia. However, certain features of stent installation should be considered. In our opinion, DD with proximal disclosure is more convenient due to better visual positioning of stent.