Palliative treatment of inoperable malignant esophageal strictures with conically shaped covered self-expanding stents

Purpose: To investigate the effectiveness of conically shaped covered self- expanding (Flamingo) stents in palliative treatment of malignant esophagoga stric strictures in terms of patency, improved dysphagia score and survival . Material and Methods: Flamingo stents were placed under fluoroscopic guidan ce between August 1998 and December 1999 for palliation of malignant dyspha gia in 33 cases. There were 21 males and 12 females aged 40-80 years (avera ge 64.2 years). Results: Stent placement was successful in all patients, with good symptoma tic control and no procedure-related complications. Spontaneous esophagores piratory fistula and perforation accompanying malignant esophageal structur e in a total of 4 cases (12.2%) were successfully closed. In 1 case, tumor ingrowth was detected from the distal uncovered segment of the stent. In 2 cases with esophago-respiratory fistula, gastrointestinal bleeding occurred . The cause of hemorrhage could not be found by angiography. The mean survi val time in 17 patients, later deceased, was 129 days (range 9-360), and th e mean observation time in 16 patients still alive is 180 days (range 18-36 5). Conclusion: Flamingo stents provide an effective and safe choice of palliat ive therapy in inoperable malignant esophagogastric strictures.