Atkinson tubes are a good cost-effective means of palliating inoperable oesophageal malignant strictures: an eight-year experience

Objective To determine how many oesophageal and oesophago-gastric malignanc ies could be successfully intubated endoscopically with an Atkinson tube, a nd how often a metal mesh tube would be required instead. Design A consecutive series of 125 patients underwent endoscopy and intubat ion. Methods A total of 142 Atkinson tubes were inserted into 122 patients, and four metal mesh stents were put into three patients. The median hospital st ay was 3 days, and 28 patients were treated as day cases. Results Atkinson tube insertion failed in only one patient. There were eigh t oesophageal perforations (5.6%); the procedure-related mortality was 4%. Three patients required a metal mesh stent, as dilatation proved difficult because of prior radiotherapy in two and prior surgery in one. Conclusion Atkinson tubes are the stents of choice for inoperable oesophage al tumours because of low complication rates and cost efficiency, In 20% of patients, day case insertion was successful. Metal mesh stents should be r eserved for those patients with tight post-radiotherapy or post-surgical st rictures when dilatation is difficult. Eur J Gastroenterol Hepatol 12:751-7 53 (C) 2000 Lippincott Williams & Wilkins.