ESOPHAGEAL STENT WITH ANTIREFLUX VALVE FOR TUMORS INVOLVING THE CARDIA - WORK-IN-PROGRESS

PURPOSE: To describe an esophageal stent with a polyester mesh cover a nd an antireflux valve, and to assess its efficacy in the treatment of patients with inoperable tumors of the gastric cardia, MATERIALS AND METHODS: Thirteen patients with adenocarcinoma of the cardia, two pati ents with squamous cell carcinoma, and three patients with recurrent c arcinoma of the gastric fundus after surgery were treated by placement of an esophageal stent with an antireflux valve. The spiral Z stent h as a porous, polyester mesh cover and an antireflux sleeve made of pli able polyurethane at its lower end. RESULTS: Placement of the stent wa s successful in all patients, and their dysphagia disappeared or signi ficantly improved. All were able to swallow solid food, and no patient reported significant reflux or ''gas bloat'' syndrome prior to death or the end of follow-up, Two patients only complained of minor heartbu rn. Follow-up barium swallow studies showed the absence of significant gastroesophageal reflux in all patients. No stent migration occurred. CONCLUSION: The esophageal stent with antireflux valve has been effec tive in the treatment of malignant obstruction of the cardia and allow ed good esophageal passage without migration and major gastroesophagea l reflux.