Follow Up and Management of Complications from Metal Self Expanding Oesophageal Stents for Malignancy

Aims: We assessed efficacy, survival time post stenting, complication rate, reintervention rate, time to discharge post stenting and readmission rate.

Methods: A consecutive series of 67 patients underwent endoscopic placement of a metal self expanding stent was identified from a prospective endoscopy database. Data was obtained from charts.

Results: The underlying cause for malignant strictures were oesophageal adenocarcinoma in 39, oesophageal squamous cell carcinoma in 16, carcinoma of unknown histology in 6 and lung carcinoma in 6. Early complications (<30days) occurred in 23.8%; included pain (n=7), aspiration pneumonia (n=2), food bolus obstruction (n=4), haematemesis (n=1). All patients experienced a subjective improvement in dysphagia. Mean hospital stay post index stent was 9.7 days. Late complications (>30days) occurred in 15%; included tumour overgrowth (n=6), stent migration (n=3), haematemesis (n=1). 6 patients with tumour overgrowth were treated successfully with an overlapping metal stent. 2 patients with migrated stents were successfully treated with placement of metal stents while 1 could not be treated because of an impacted stent. Mean survival time post index stenting was 96 days (range 0–677 days). Readmission rate was 51%.

Conclusions: We confirm that metal self expanding stents are effective and safe for the management of malignant oesophageal strictures.