TY - JOUR
T1 - Feasibility, efficacy and safety of stent insertion as a palliative treatment for malignant strictures in the cervical segment of the esophagus and the hypopharynx
AU - Battaglia, Giorgio
AU - Antonello, Alessandro
AU - Realdon, Stefano
AU - Cavallin, Francesco
AU - Giacomini, Francesca
AU - Ishaq, Sauid
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background: 50 % of esophageal cancers are inoperable at the time of diagnosis, and around 15 % involve the cervical esophagus. The hypopharynx is often involved by these malignancies as well. Palliation of cervical esophageal malignancies through stent insertion is considered limited due to technical challenges, poor patient tolerance and high complication rate. The aim of this study is to review our experience with stent insertion in the cervical segment of the esophagus and to evaluate outcome differences between stent insertions involving or sparing the hypopharynx. Methods: We retrospectively reviewed data on 69 consecutive patients that underwent stent insertion for malignant strictures in the cervical esophagus at our Department. Patients were divided according to involvement or sparing of the lower hypopharynx. Dysphagia severity was measured with the Mellow–Pinkas scale before the procedure and on monthly follow-ups. Any complication and its management were recorded. The main outcome parameters were as follows: dysphagia improvement, rate of successful dysphagia palliation (i.e., a reduction of the score to 0 or 1 after stent insertion) and complication rate. Multivariable analysis was carried out to assess the influence of patient- and procedure-related factors on the outcome of the procedure. Results: Stent insertion was achieved in 100 % patients. At 4 weeks, dysphagia score improved from a median of 3–0 (p
AB - Background: 50 % of esophageal cancers are inoperable at the time of diagnosis, and around 15 % involve the cervical esophagus. The hypopharynx is often involved by these malignancies as well. Palliation of cervical esophageal malignancies through stent insertion is considered limited due to technical challenges, poor patient tolerance and high complication rate. The aim of this study is to review our experience with stent insertion in the cervical segment of the esophagus and to evaluate outcome differences between stent insertions involving or sparing the hypopharynx. Methods: We retrospectively reviewed data on 69 consecutive patients that underwent stent insertion for malignant strictures in the cervical esophagus at our Department. Patients were divided according to involvement or sparing of the lower hypopharynx. Dysphagia severity was measured with the Mellow–Pinkas scale before the procedure and on monthly follow-ups. Any complication and its management were recorded. The main outcome parameters were as follows: dysphagia improvement, rate of successful dysphagia palliation (i.e., a reduction of the score to 0 or 1 after stent insertion) and complication rate. Multivariable analysis was carried out to assess the influence of patient- and procedure-related factors on the outcome of the procedure. Results: Stent insertion was achieved in 100 % patients. At 4 weeks, dysphagia score improved from a median of 3–0 (p
KW - Endoscopy, gastrointestinal
KW - Esophageal neoplasms
KW - Esophageal sphincter, upper
KW - Palliative care
KW - Stents
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U2 - 10.1007/s00464-015-4176-z
DO - 10.1007/s00464-015-4176-z
M3 - Article
C2 - 25829063
AN - SCOPUS:84955213931
VL - 30
SP - 159
EP - 167
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 1
ER -