Ashok Katti MD, Presenter: Nothing to Disclose

Gian Abbott, Abstract Co-Author: Nothing to Disclose

Esophageal cancers have high rates of mortality. 60% of newly diagnosed cases are deemed unfit for surgery. The palliative use of self-expanding metallic stents has been widely reported to relieve dysphagia in cases of esophageal carcinoma. We present our practice, experience, success and complications of fluoroscopic guided upper GI stenting in 63 cases over 14 months.

63 patients with inoperable esophageal and gastric cancer underwent stent placement between October'04–November'06. Age, sex, indications, type of stents used, site and pathology of lesions, type of anesthesia, contrast swallow results, success rate, post procedure early and late complications, hospital stay, readmission days, duration of stent in patients and patient survival time were assessed.

Patients age ranged from 46–95 years(80% >61 years). M:F ratio was 40:23. Predominant indication in 42(66%)was esophageal carcinoma with dysphagia. Others were 8(12%) CA pylorus/anastomotic stricture with vomiting, 7(11%) previous stent related complications (migration/block/fracture), 2(3%) for benign strictures and 2(3%) CA bronchus with T-E fistula. 37(58%) patients were stented across the distal esophagus stricture. Eight(12%) contrast swallows showed stent related changes: migration/impaction/wasting. We had 95% success rate in stenting. Common early post procedure symptoms were chest pain(15%), regurgitation/vomiting. Late complications included stent migration(8%), stent impaction(8%), stent block(6%) and stent fracture(2%). Hospital stay ranged from 1–45 days. Most(50%) of them stayed for 2-3days. Duration of stent in patients ranged from 2–498 days with average of 102days. 28(46%) patients had the stent for less than 50 days. The median survival time was 75 days post stenting (range 2–498).

Fluoroscopic guided insertion of self expanding metallic stents for upper GI malignant strictures has good success rates and provides symptomatic relief of dysphagia in inoperable patients.

Fluoroscopic guided esophageal stenting for palliating upper gi malignant strictures has a good success rate and avoids the need for endoscopic guidance for stenting.

Katti, A, Abbott, G, Fluoroscopic-guided Palliative Stenting for Upper Gastrointestinal Malignant Strictures: Technique, Success, Complications, and Outcome.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5012030.html