Palliative Therapy Using Polyurethane-covered Self-expandable Metallic Stents for Malignant Esophageal Strictures: Experiences in Six Patients

To evaluate the utility and limitations of palliative stentingwith polyurethane-covered self-expandable metallic stents, 6patients (3 males and 3 females ranging in age from 58–85[mean 72.1] years) with malignant esophageal strictures weretreated with these stents between April 1993 and October 1995.Three had esophageal carcinoma, two had gastric carcinoma andone had lung carcinoma. Song-type self-expandable metallic stentswere inserted by intubation under local laryngeal anesthesia.A retriever was attached in 4 stents and an anti-reflux mechanismwas attached in 2 stents placed over the esophagocardiac strictures.The stents were placed successfully in all patients, and nomajor complication related to intubation was encountered. Allthe stents fully expanded within 3 days after insertion. Thegrade of dysphagia was improved in 5 (83%) of the 6 patients.One stent was extracted using a retriever in one patient withno improvement. No reflux symptoms were observed in 2 patientswhom received stents with an anti-reflux mechanism. No blockageof the stent due to food impaction or secondary stricture occurredin any patient during the observation period. One stent migratedinto the stomach in one patient 27 days after insertion. Esophagealstenting with polyurethane-covered self-expandable metallicstents is a relatively safe and effective palliation for malignantesophageal strictures.