Esophacoil expanding stent in the management of patients with nonresectable malignant esophageal or cardiac neoplasm: A prospective study

Background and Study Aims: In this prospective study we evaluated the use o f the self-expanding Esophacoil stent for palliation in patients with non-r esectable malignant tumors of the cardia and esophagus, The stent has some obvious advantages from a theorectical point of view, namely a wide diamete r and strong forces of expansion and retraction, which prevent migration an d tumor overgrowth, Its considerable flexibility facilitates insertion of t he stent into tortuous and angulated passages. Patients and Methods: A total of 30 patients participated in the study. The tumor was located in the lower esophagus or cardia in 15 patients, in the mid-esophagus in sig and in the upper oesophagus in two patients. More than two-thirds of the esophagus was involved in three patients and four had a recurrence in an esophagogastric anastomosis, Results: The procedure was successful in 29 of 30 patients. The overall hos pital mortality was 10%, One death from gastrointestinal haemorrhage follow ing insertion of the stent was directly procedure-related. The morbidity re lated to the procedure was 10%, The median time in hospital after stent ins ertion was 1 day (range 1-9), All the patients could manage a semi-solid di et after stent insertion. Survival after discharge did not exceed 8 months and the median survival was 63 days. Of the patients, 22 (81%) needed no fu rther intervention or hospital admission because of the stents, Three had t umor overgrowth or ingrowth, and one stent migrated after the patient was d ischarged and passed spontaneously per anum, Conclusion: Insertion of an Esophacoil metal stent into malignant stricture s of the esophagus and cardia is a fairly simple and safe procedure. Dyspha gia is significantly relieved, initially, with few long-term side effects. In the short span of time left for the patients, the need for further treat ment after discharge is minimal, but swallowing ability gradually deteriora tes in the terminal phase.