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.