1. Fully covered self-expandable esophageal metallic stents in patients with inoperable malignant disease who survived for more than 6 months after stent placement.
- Author
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Bakheet, Nader, Park, Jung-Hoon, Hu, Hong-Tao, Yoon, Sung Hwan, Kim, Kun Yung, Zhe, Wang, Jeon, Jae Yong, and Song, Ho-Young
- Subjects
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SURGICAL stents , *PROGRESSION-free survival , *MULTIVARIATE analysis , *THERAPEUTICS , *CONFIDENCE intervals , *DEGLUTITION disorders - Abstract
To investigate the clinical outcomes of fully covered self-expanding metal stent (FCSEMS) placement in patients with malignant esophageal obstruction who survived longer than 6 months. From January 2002 to January 2018, 88 FCSEMS were placed in 64 patients (mean age 62.9 ± 11.6 years; 58 males) with inoperable malignant esophageal obstruction with or without esophago-respiratory fistula. Only patients who survived more than 6 months with FCSEMS in place were included. Data regarding technical and clinical success, complications, reinterventions, stent patency, and patient survival were obtained from a prospectively maintained hospital database. The technical and clinical success rates were 100 % (64/64). During follow-up, the median dysphagia score significantly improved (3.09 ± 0.68 to 1.05 ± 0.60, p < 0.001). The complication rate was 48.8 %. Multivariate analysis revealed that only longer stenting duration was associated with complications [hazard ratio = 1.220, 95 % confidence interval (CI) (1.074–2.760), p = 0.039]. The median follow-up duration was 257 days (range, 181–969). The median stent patency duration was 289 days [95% CI (209.9–368.1)]. The median survival was 254 days [95% CI (219.7–288.3)]. Our data suggest that esophageal FCSEMS placement is an effective option for patients with malignant dysphagia when survival longer than 6 months is expected. The rate of complications increases with time, and SEMS development is needed to keep up with the advancement in oncological treatment. Fully covered esophageal self-expandable stent placement is effective in patients surviving more than 6 months, however, the rate of complications also increases. SEMS development is needed to cope with the advancement in oncological treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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