THE CLINICAL EFFECTIVENESS OF THE GIANTURCO ESOPHAGEAL STENT IN MALIGNANT ESOPHAGEAL OBSTRUCTION

Between January 1994 and December 1996 72 patients were treated with 7 6 Gianturco oesophageal stents for oesophageal obstruction or perforat ion. The patients were followed prospectively in order to determine th e effectiveness in improving dysphagia, to establish long term patency , survival times and complications. The mean dysphagia score prior to stenting was 3, improving to a mean score of 1 after stenting. Swallow ing failed to improve in three patients. No serious complications were seen at stent insertion. Patients tolerated the procedure well with n o complications in 63%. The most frequent immediate complication was c hest pain occurring in 15 patients (21%), This settled in all patients with appropriate analgesia, however, four patients required long-term pain relief. In no cases was the chest pain due to perforation. Re-in tervention was required in 16.7% of patients, the commonest cause bein g tumour overgrowth, and this was seen primarily in patients with long survival, The migration rate was low, despite the fact that 45 of 76 stents had been placed with the distal end in the stomach. Only four s tents (5.6%) migrated completely, all of which had been deployed acros s the cardia, In our series the use of the Gianturco oesophageal stent s for provided effective palliation of malignant oesophageal obstructi on.