Expandable metallic stents in the management of malignant oesophageal obstruction

Background: Malignant oesophageal obstruction with an advanced disease pres ents a difficult challenge. A new class of metal stents have been developed to overcome the limitations of existing treatment modalities. Methods: We present our first 58 patients, who have been treated with self- expandable metallic stents, using sedation anaesthesia, with fluoroscopic a nd endoscopic control. Both kinds of stents, covered and uncovered, were ap plied. Results: There was no procedure-related mortality. The immediate relief of dysphagia was 98 %. All four oesophageal fistulas were successfully sealed with covered stents. Due to stent migration, tumour overgrowth, or ingrowth , twelve (21 %) of the patients needed re-intervention. Restenting or laser therapies were used against recurrent dysphagia. Conclusion: The palliation of oesophageal malignant obstruction with metal stents is a rapid, effective, and relatively safe single treatment which ca n be employed as part of a multimodal treatment program.