Abstract
Background and Study Aims: Tumor ingrowth through self-expanding metal stents presents a difficult problem for
management. The techniques for treating tumor ingrowth have not yet been well described,
and the optimal endoscopic approach is not clear. We have recently used photodynamic
therapy (PDT) to treat tumor ingrowth through uncovered nitinol mesh stents.
Patients and Methods: Four patients (mean age 73) with obstructive adenocarcinomas of the distal esophagus
had received self-expanding stents for palliation of their dysphagia. After stent
placement, tumor ingrowth had caused progressive dysphagia in all of the patients;
the dysphagia was graded on a scale from 0 (normal) to 4 (inability to swallow liquids).
All of the patients received PDT treatment.
Results: After PDT, excellent palliation of the dysphagia was seen in all of the patients,
with a mean improvement in the dysphagia score of 2.25 and a mean dysphagia-free interval
of 92 days. There were no major complications.
Conclusion: The use of PDT to treat tumor ingrowth through self-expanding metal esophageal stents
is effective and safe.
