Palliation of patients with esophagogastric neoplasms by insertion of a covered expandable modified Gianturco-Z endoprosthesis: experiences in 153 patients

Background: We aimed to evaluate the short- and long-term outcomes of treat ment by insertion of a covered expandable modified Gianturco-Z endoprosthes is (Song stent) in patients with esophagogastric malignancies. Methods: Consecutive patients with esophagogastric malignancies in whom a S ong stent was inserted were included, Data were retrieved retrospectively. Dysphagia before and after stent placement was scored on a 5-point scale. E arly (less than 30 days) and late complications (more than 30 days) were sc ored. Results: Analysis included 164 stents in 153 patients. Indications for sten t placement were dysphagia and/or fistulas/perforations. The dysphagia scor e improved from a mean of 3.7 to 2.2 after stent placement (p < 0.0001), Fi stulas/perforations sealed in 87% of cases. Early complications after stent placement occurred in 29.9% of cases. These included stent migration (4.3% ), stent obstruction (6.1%), aspiration pneumonia (4.9%), bleeding (4.3%), perforation (1.8%), and pain (15.9%), Late complications occurred in 27.8% of cases. These included stent migration (2.6%), stent obstruction (9.6%), aspiration pneumonia (2.6%), bleeding (7.0%), perforation (0.9%), and pain (12.2%), The 30-day mortality was 26%, Death related to stent placement occ urred in 3.3%, Conclusion: Insertion of a Song expandable endoprosthesis in patients with esophagogastric malignancies significantly improves dysphagia, is successfu l in sealing fistulas/perforations, and is associated with acceptable morbi dity and mortality rates.