Long Term Outcome Of Self Expanding Metal Stems (Sems) For Palliation Of Dysphagia In Esophageal Malignancies

Aim: to evaluate if self-expanding metal stents improve the dysphagia and general status in patients with esophageal carcinoma. Patients and Methods: From June 1995 to November 2006, 153 SEMS were placed in 151 patients, (118 m. and 33 f., mean age 66.3 years), for palliation of malignant dysphagia in a prospective study in our service. The criteria for evaluation were: clinical (dysphagia score, and karnofsky score), X-ray and endoscopy. Late complications were considered when they occurred after thirty days after the placement of the stent. Results: one hundred and twenty patients (79.47%) were finally included for follow-up. The late complication rate was 23/120 (19.16%), 7 migrations; 5 tumour overgrowth; 1 ulceration; 6 severe chest pain; 1 granulation tissue ingrowth; 3 esophagopleural fistula. Twenty two (95.65%) complications were clinically and endoscopically treated. One case was sent to surgery. The median survival was 5.9 months (range 1 to 16 m). The dysphagia score improved in two points in 36% of the patients and in one point in 32.4% of the patients and the karnofsky score increased in ten points in 34.5% over the baseline. Conclusions: we believe that self expanding metal stents are a good option for patients with unresectable esophageal carcinoma and improve the dysphagia and general status). The late complication rate is similar to the plastic ones according data published.