PALLIATION OF INOPERABLE ESOPHAGEAL-CARCINOMA WITH THE WALLSTENT ENDOPROSTHESIS

Background. Palliation of malignant dysphagia can be achieved by inser tion of an endoprosthesis. Recently, metallic self-expanding prosthese s have been introduced that offer the advantage of a lower complicatio n rate over their plastic counterpart. Methods. Thirteen patients with dysphagia due to inoperable carcinoma of the esophagus were treated w ith coated Wallstent (Schneider (USA) Inc, Minneapolis, MN) endoprosth eses, which were placed under fluoroscopic control. All patients were given general anesthesia during the procedure. Results. After successf ul insertion of al! endoprostheses, the dysphagia of 12 of the patient s improved while in the hospital. Average length of stay was 4.4 days. Two patients required a second stent because of migration or tumor ov ergrowth. Seven patients died with a mean survival of 54 days (range, 14 to 144 days), and 6 are alive a mean of 112 days (range, 32 to 263 days) after treatment. Conclusions. Coated Wallstent insertion is an e ffective, single treatment that quickly improves the patients' quality of life. Its effect on survival is yet to be established when used as a last resort in patients with inoperable esophageal carcinoma and po or general condition.