Management of inoperable malignant oesophageal strictures with fully covered wallflex® stent: A multicentre prospective study

Alessandro Repici, Manol Jovani, Cesare Hassan, Biagio Solito, Roberto Di Mitri, Federico Buffoli, Giovanni Macrì, Diego Fregonese, Vincenzo Cennamo, Mario De Bellis, Andrea Anderloni, Peter D. Siersema

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The majority of currently available oesophageal metal stents are partially covered to reduce migration risk. Preliminary experiences with fully covered stents seem to indicate an increased risk of migration in patients treated for malignant dysphagia. The aim of our study was to determine, in this setting, the safety and efficacy of a new, recently introduced stent with anti-migration proprieties. Methods: We designed a prospective, multicentre, non-randomized, follow-up study in nine tertiary referral centres. Eighty-two patients with dysphagia due to inoperable or metastatic oesophageal cancer were included. In all of them the fully covered WallFlex® stent was placed. Main outcome measurements included functional outcome, recurrent dysphagia, complications, and mortality. Results: Dysphagia score improved from a median of 3, before stenting, to 1 at 4 weeks after stent placement (P <0.001). Perforation occurred in 1 patient after 39 days, while bleeding was reported in 3. In total, 19 patients (23.1%) developed recurrent dysphagia because of stent migration (N = 10, 12.2%), tissue overgrowth (N = 7; 8.5%), and food impaction (N = 2; 2.4%). Conclusions: Placement of the fully covered WallFlex® stent resulted in safe and effective palliation of malignant dysphagia, with migration and tissue overgrowth rates comparable to previously reported data on partially covered stents.

Original languageEnglish
Pages (from-to)1093-1098
Number of pages6
JournalDigestive and Liver Disease
Volume46
Issue number12
DOIs
Publication statusPublished - 2014

Keywords

  • Advanced oesophageal cancer
  • Nutrition
  • Palliation
  • Self-expanding metal stent
  • Sems

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

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