Adaptation of endovascular technique of self-expandable metal esophageal stent implantation in palliative treatment of malignant dysphagia in the course of esophageal and bronchial cancers: A one-center study

Damian Ziaja; Bartłomiej Stasiów; Mariola Sznapka; Jolanta Domalik; Wacław Kuczmik; Krzysztof Ziaja; Jerzy Chudek

doi:10.17219/acem/111810

Adaptation of endovascular technique of self-expandable metal esophageal stent implantation in palliative treatment of malignant dysphagia in the course of esophageal and bronchial cancers: A one-center study

Adv Clin Exp Med. 2020 Nov;29(11):1363-1366. doi: 10.17219/acem/111810.

Authors

Damian Ziaja^{1

2}, Bartłomiej Stasiów³, Mariola Sznapka², Jolanta Domalik⁴, Wacław Kuczmik², Krzysztof Ziaja², Jerzy Chudek⁵

Affiliations

¹ Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland.
² Department of Department of General and Vascular Surgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland.
³ Department of Radiology, Upper-Silesian Medical Centre in Katowice of Medical University of Silesia in Katowice, Poland.
⁴ Department of General, Vascular and Transplant Surgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland.
⁵ Department of Internal Diseases and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland.

PMID: 33269824
DOI: 10.17219/acem/111810

Abstract

Background: Esophageal stent implantation is an alternative for microjejunostomy or total parenteral nutrition in the palliative treatment of malignant dysphagia in the course of esophageal and advanced bronchial cancers infiltrating the esophagus. The procedure of implanting an esophageal self-expanding metal stent (SEMS) is performed with gastroscopic guidance under general anesthesia.

Objectives: To analyze the efficacy and safety of a simplified technique (without gastroscopic guidance in local anesthesia) of esophageal SEMS implantation in patients with malignant dysphagia in the course of esophageal and bronchial cancers.

Material and methods: This is a retrospective analysis of consecutive procedures of uncovered esophageal SEMS implantation performed with a simplified adaptation of the endovascular technique (Seldinger wire) in patients with esophageal and bronchial cancers and poor performance status. The procedures were done in a single surgical center over an 8-year period in 27 patients who were referred from oncology departments with esophageal stenosis confirmed using gastroscopy and who were being treated for malignant dysphagia. The study endpoints were effectiveness (a decrease in dysphagia from grade 3 or 4 to grade 1 after the procedure) and complications related to the procedures (including restenosis and stent migration).

Results: In all 27 patients, the SEMS were effectively implanted, enabling enteral nutrition after the procedure. No early complications related to the procedure were observed. A single patient developed restenosis 14 days after the procedure, which required re-stenting.

Conclusions: The simplified method for SEMS implantation described herein may be considered an option in the palliative treatment of patients with malignant dysphagia in the course of esophageal and bronchial cancers and poor performance status, especially in facilities with limited access to endoscopy.

Keywords: bronchial cancer; esophageal cancer; malignant dysphagia; palliative treatment; self-expandable metal esophageal stent implantation.

MeSH terms

Deglutition Disorders* / etiology
Deglutition Disorders* / therapy
Endovascular Procedures*
Esophageal Neoplasms* / complications
Humans
Palliative Care
Retrospective Studies
Stents
Treatment Outcome