Eficacia de un nuevo stent de nitinol fabricado localmente, en el tratamiento de la obstrucción maligna esofágica

objectives: esophageal strictures and esophagorespiratory fistulas are complications of malignant esophageal tumors and benign conditions, which are difficult to manage. the efficacy of a locally (medellín-colombia) produced self-expanding metal stents (sems) for palliation of malignant esophageal strictures and fistulas was investigated prospectively. methods: eighty one sems were inserted in 77 patients, 73 patients with malignant esophageal stricture (10 with fistula) and 4 benign. our series included 45 men and 32 women, of whom median age was 65 years. sixty three stents were inserted for malignant strictures, ten for esophago-tracheal fistula, and four for benign conditions. stents were inserted endoscopically only in 83% and under endoscopy and fluoroscopic control in 17%. results: sems implantation was technically successful in 100%. a second stenting was needed in four patients. median dysphagia score improved from 2,8 to 1,4 (p<0,01). the covered sems was succesful in completely sealing 100% of the fistulas. complication occurred in 28,4% patients. procedure-related mortality was 0%. conclusions: we conclude that treatment of malignant esophageal obstructions, including esophagorespiratory fistulas, with sems locally produced is a good alternative palliative procedure. furthermore sems implantation seems safe in the case of benign stenoses.