Palliation of malignant esophageal obstruction and fistulas with covered self expandable metallic stents: assessment of a simple fluroscopic method

Purpose: To introduce a convenient, quick and effective way to place self-expandable metal stents (SEMSs) to relieve dysphagia and fistula caused by esophageal carcinoma. Materials and methods: A consecutive series of 36 patients (25 men, 11 women), aged 38-82 years (median, 52.7 years) underwent stent placement using a 7F long sheath of 55 cm and fully covered SEMS under local anesthesia with fluoroscopic control. Results: Stent placement was successful in all patients. Swallowing improved from mean dysphagia score 3.44 +/- 0.50 to score 0.69 +/-0.71 (P = 0.000). There were no clinically significant complications during and after the deployment of stents. Migration was noted in 4 patients. Restenting was needed in 3 patients. Removal was needed in 2 patients. Mean survival following stenting was 134.14 d. Conclusions: SEMSs provide rapid, safe and effective relief of dysphagia and fistula. Using the 7F long sheath of 55 cm could make the procedure easy, quick and safe.