Abstract
The effects and problems of metallic stents were clinically examined in 32 patients with advanced esophageal carcinoma for the period from May 1996 to May 2000 at the Kanagawa Cancer Center. Chemotherapy and/or radiation therapy were performed in 30 of these patients. They were 24 patients (75%) with esophageal stenosis and 8 patients (25%) with tracheoesophageal fistula caused by esophageal carcinoma before stenting. We used a covered Ultraflex in 27 patients, an uncovered Ultraflex in 4 patients, and a Wallstent in one patient. Metallic stents were successfully implanted in all patients in our series. But the tracheoesophageal fistula in one patient was could not be intercepted completely after placement of the metallic stent. An improvement in oral intake was seen after stenting in 30 patients (93.8%). Leaving the hospital was possible in 14 patients (43.8%). The median survival of all patients after placement of the metallic stent was 54 days. The following device-related complications were seen: migration of the stent in four patients (12.5%), bleeding after stenting in one patient, and esophageal perforation in one patient were seen. Tumor ingrowth was recognized in two patients (6.3%). Moreover, hemorrhages (hematemesis and hemoptysis) near death were seen in 12 patients (37.5%). The majority of the causes of the bleeding in them were due to tumor factors.
