Self-expandable Metallic Stent Insertion for Nonresectable Esophageal Cancer Patients

Abstract

Esophageal stent insertion is useful as a procedure for terminal cases such as those with inoperable advanced cancer or esophagobronchial fistula. We are trying to use stents especially with patients complaining of dysphagia who do not have an expected long survival to improve their QOL.
We studied the timing of the use of SEMS and evaluated the effects of additional therapy.
SEMS were indicated in 23 cases from April, 1994. The causes of unresectability was as follows: 16 cases due to tumor, 4 due to tumor and the general condition of the patients, 3 due to general condition. The location of the main lesions were Ut in 10 cases, Mt in 10 cases, Lt in 3 cases. Longitudinal size ranged from 6 to 12 cm (mean: 9.3 cm). Concerning the timing of the SEMS induction, stents were inserted before or after the beginning of treatment in 11 cases, and after treatment in 12 cases, SEMS allowed oral intake just after insertion and improved QOL without complications.
SEMS insertion can be expected to maintain oral intake during therapy and prevent aspiration in patients with oral dilatation of the esophagus before stenosis. Moreover, CT was considered necessary before and after insertion of stents to detect the tracheal deviation and compression by tumors— especially in cases with cancer located in Ut— and evaluate to effects of additional therapy.