[The palliative treatment of malignant esophageal stenosis and fistulae with self-expanding metal prostheses]. / Tratamiento paliativo de las estenosis y fístulas esofágicas malignas mediante prótesis metálicas autoexpandibles.

ABSTRACT

OBJECTIVE: To evaluate the efficiency of self-expanding metal stents (SES) for the palliative treatment of malignant oesophageal strictures and fistulas. MATERIAL AND METHODS: Fifty non-operable patients with malignant oesophageal strictures and/or fistulas were treated with SES placement. All patients had dysphagia, the mean degree for the studied group being 3.36. Ten patients presented associated tumoral fistula. Uncoated SES were placed for simple stenosis cases and coated SES for cancers with associated fistulas. RESULTS: A improvement in dysphagia was obtained in 47 patients (94%). The mean degree of dysphagia after the procedure was 1.12. In nine patients (90%) the fistula closed with resolution of the associated clinical picture. Complication were observed in six patients (12%), the perioperative mortality rate being 2%. During follow-up, twelve patients (25%) had malfunction of the stent, which was successfully treated in eight patients. CONCLUSION: SES are efficient for the palliative treatment of malignant oesophageal strictures and/or fistulas, but not commonly re-interventions are necessary to maintain a long-term functionality.