Endoprosthesis implantation at the pharyngo-esophageal level: problems, limitations and challenges

World J Gastroenterol. 2006 Apr 7;12(13):2103-8. doi: 10.3748/wjg.v12.i13.2103.

Abstract

Aim: To present our experience with endoscopic placement of an esophageal endoprosthesis in 19 patients.

Methods: A retrospective evaluation was made for the use of 19 stents positioned at the level of the cervical esophagus: 11 for malignant tumours (7 causing obstruction, 4 complicated by an esophago -tracheal or -cutaneous fistula), and 8 for an acquired benign tracheo-esophageal fistula due to prolonged intubation. The covered Ultraflex stent was used in all cases except two. These two patients had an esophagocutaneous fistula following laryngectomy and a Flamingo Wall stent was used.

Results: Stent implantation was technically successful in all patients. Dysphagia score was improved from 3 to 2 in stenosis patients, while sealing of the fistula was achieved in all cases. The median hospital stay was 3 d for malignant tumour patients and 13.5 d for esophagocutaneous fistula patients. One Ultraflex stent and two Flamingo Wall stents were easily removed 33 d and 3 months respectively after implantation when the fistulas had totally occluded.

Conclusion: Endoprosthesis implantation for malignancy and/or fistula of malignant or benign origin at the level of the cervical esophagus is an easy, well tolerated, safe and effective procedure with no complications or mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Esophageal Fistula / surgery*
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / surgery*
  • Esophageal Stenosis / surgery*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pharyngeal Neoplasms / complications
  • Pharyngeal Neoplasms / surgery*
  • Prosthesis Implantation / methods*
  • Retrospective Studies
  • Stents*