Palliative treatment of inoperable malignant esophageal strictures with conically shaped covered self-expanding stents.

ABSTRACT

PURPOSE: To investigate the effectiveness of conically shaped covered self-expanding (Flamingo) stents in palliative treatment of malignant esophagogastric strictures in terms of patency, improved dysphagia score and survival. MATERIAL AND METHODS: Flamingo stents were placed under fluoroscopic guidance between August 1998 and December 1999 for palliation of malignant dysphagia in 33 cases. There were 21 males and 12 females aged 40--80 years (average 64.2 years). RESULTS: Stent placement was successful in all patients, with good symptomatic control and no procedure-related complications. Spontaneous esophago-respiratory fistula and perforation accompanying malignant esophageal stricture in a total of 4 cases (12.2%) were successfully closed. In 1 case, tumor ingrowth was detected from the distal uncovered segment of the stent. In 2 cases with esophago-respiratory fistula, gastrointestinal bleeding occurred. The cause of hemorrhage could not be found by angiography. The mean survival time in 17 patients, later deceased, was 129 days (range 9--360), and the mean observation time in 16 patients still alive is 180 days (range 18--365). CONCLUSION: Flamingo stents provide an effective and safe choice of palliative therapy in inoperable malignant esophagogastric strictures.