Self-expanding esophageal metallic stents in the treatment of esophageal obstruction

Esophageal obstruction from any cause is debilitating. In patients with mal ignant obstruction palliation to relieve pain and dysphagia is the primary goal. Conventional endoluminal prostheses allow variable palliation. Covere d expandable metallic stents with an 18-mm lumen allow improved deglutition , From December 1994 through December 1998, 59 patients underwent placement of self-expanding silicone-covered esophageal stents for esophageal obstru ction. There were 36 men and 23 women ranging in age from 41 to 94, All pat ients underwent esophageal dilation using a flexible gastroscope and Savary bougies, After dilation placement of the stent was performed under fluoros copic control, Follow-up was complete in all patients. Technical success wa s achieved in all patients. There was one postoperative death (bronchopulmo nary fistula), one migration of the stent requiring removal, and one recurr ent obstruction. The remaining stents were well tolerated even in the cervi cal region (four patients), All patients returned to a diet of solid foods. We conclude that covered self-expanding esophageal metallic stents are tec hnically simple and safe to insert and appear to provide durable excellent palliation of esophageal obstruction due to either benign or malignant cond itions.