PALLIATIVE TREATMENT OF MALIGNANT DYSPHAG IA WITH THE STRECKER STENT

OBJECTIVE: TO evaluate the effectiveness of metallic Strecker stents f or palliation of malignant dysphagia. PATIENTS AND METHODS: From June 1992 to August 1995, 66 Strecker stents were inserted in 55 consecutiv e patients, 50 male and 5 female, with a mean age of 62 years (range 2 5-83). The cause of dysphagia was incurable malignant obstruction of t he esophagus. Three patients presented with dysphagia grade I, 8 grade II, 27 grade III and 17 grade IV. All the procedures were performed u nder fluoroscopic control, RESULTS: Exact positioning of the stent was technically feasible in all patients. No procedure-related mortalitie s or major complications ocurred, Immediate complications were transie nt chest pain (n = 11), blood stain sputum (n = 8) and gastroesophagea l reflux (n = 8). During follow-up, 7 patients (12.7%) had recurrent d ysphagia due to tumor ingrowth or overgrowth. In these patients an add itional overlapping stent was successfully placed in six cases and bal loon dilatation in one. Latest evaluation revealed dysphagia grade 0 i n five patients (9%), 10 dysphagia grade I (18%), 14 grade II (25%), 1 3 grade III (23.6%) and seven grade IV. CONCLUSIONS: Implantation of S trecker stents is an effective and safe method of palliating severe ma lignant dysphagia. Placement of the stents was feasible without major procedure complications.