Placement of PEG tubes through previously placed self-expanding esophagealmetal stents

Background. Self-expanding metal stents are frequently used to palliate pat ients with malignant dysphagia and close tracheoesophageal fistulae. Despit e proper stent positioning and deployment, in a subset of patients there is no improvement in dysphagia, closure of tracheoesophageal fistulae, or res olution of anorexia. Such patients may require a PEG tube. It has been sugg ested that PEG placement through a preexisting esophageal stent is problema tic because of the risks of gastrostomy tube impaction within the stent and resultant stent migration. Methods: Case records were retrospectively reviewed of 9 consecutive patien ts with indwelling esophageal self-expanding metal stents undergoing attemp ted PEG. Observations: PEG tube placement was successful in all patients. In 1 patie nt, the stent migrated distally into the stomach during PEG placement. This was managed endoscopically without further complication. Conclusions: PEG placement in patients with previously placed esophageal se lf-expanding metal stents is a relatively safe and feasible procedure, alth ough stent migration may occur.