Cs. Shim et al., Fixation of a modified covered esophageal stent: Its clinical usefulness for preventing stent migration, ENDOSCOPY, 33(10), 2001, pp. 843-848
Background and Study Aims: Membrane-covered self-expandable metal stents ar
e effective in preventing tu mor ingrowth and stent obstruction in patients
with inoperable esophageal cancer, but migration of stents continues to be
a major problem. We therefore constructed a modified covered self-expandab
le esophageal metal stent capable of being fixed using a silk thread. The s
tent was studied prospectively to define its palliative characteristics and
whether it is effective in preventing migration.
Patients and Methods: Modified covered self-expandable metal stents were pl
aced in 17 patients with malignant gastric cardiac cancer involving the eso
phagogastric junction, 41 patients with esophageal cancer, and three patien
ts with tracheoesophageal fistulas. Clinical and radiographic follow-up exa
minations were carried out at regular intervals.
Results: Placement of the stent was successful in all patients, with good s
ymptomatic relief and no serious stent-related complications such as esopha
geal perforation or hemorrhage. Acute stent placement problems, such as inc
omplete expansion or acute angulation of the stent, were noted in four pati
ents. However, during a mean follow-up period of 7.5 months (range I to 17
months), there was no stent migration.
Conclusions: Modified covered self-expandable esophageal metal stents of th
is type would be very effective in preventing stent migration, especially i
n patients with malignant gastric cardiac cancer extending to the lower eso
phagus, those with short-segment esophageal cancer, and those with tracheoe
sophageal fistulas.