Self-Expandable Metal Stents in Palliation of Inoperable Esophageal & Gastro-Oesophageal Carcinoma

Background: Most of patients with carcinoma of the esophagus are inoperable at the time of presentation. The aim of this study was to evaluate the results of self expandable metal stents for the treatment of malignant dysphagia. Material & Methods: This study was conducted at Assiut University, Egypt from July 2009 to Dec 2011. Twenty Enrolled patients with grade 3 or 4 dysphagia due to inoperable carcinoma of the esophagus and gastro-oesophageal junction underwent Self Expandable Metal Stenting under endoscopic guidance. They were followed during all the study period. Dysphagia score will be calculated at baseline and at follow up according to Atkinson’s scale. Data were analyzed using SPSS version 16. Results: Mean age of patients was 55.5±15 years with male to female ratio of 3:2. Mean dysphagia score improved from 3.4 (pre-stent) to 1.07 (post-stent) (p <0.05). Improvement in dysphagia (conversion of grade 3 or 4 dysphagia into grade 1 or 0) was seen in 90% of patients. Eight patients required re-intervention after initial improvement for their stent blockage (40%) and two patients followed conservatively for stent migration (10%). Other minor complications like cough and regurgitation occurred in 10% and 40% patients respectively. Most patients experienced severe chest pain necessitating narcotic analgesics. One patient with pulmonary metastasis died within one week, three patients died within 3months, ten patients died within 1.5 years and six patients under flow-up until now. Conclusion: Self expandable metal stents are an effective method for palliation of dysphagia but not without complications.