Bona D, Laface L, Bonavina L, Abate E, Schaffer M, Ugenti I, Siboni S, Carrinola R. Covered nitinol stents for the treatment of esophageal strictures and leaks. World J Gastroenterol 2010; 16(18): 2260-2264 [PMID: 20458763 DOI: 10.3748/wjg.v16.i18.2260]
Corresponding Author of This Article
Luigi Bonavina, Professor, Department of Medical and Surgical Sciences, Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, 20100 Milano, Italy. luigi.bonavina@unimi.it
Article-Type of This Article
Brief Article
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World J Gastroenterol. May 14, 2010; 16(18): 2260-2264 Published online May 14, 2010. doi: 10.3748/wjg.v16.i18.2260
Table 1 Indication for use of the stent in 65 patients
n (%)
Esophageal carcinoma
51 (78.5)
Adenocarcinoma
31
Squamous-cell carcinoma
20
Complications of esophagogastric anastomosis
8 (12.3)
Fistula
3
Stricture
3
Tumor recurrence
2
Extrinsic compression
4 (6.1)
Lung cancer
2
Pleural mesothelioma
1
Mediastinal lymphoma
1
Post-radiotherapy stricture
2 (3.1)
Table 2 Classification of dysphagia
Grade
Definition
0
Normal swallowing
1
Able to swallow some solid food
2
Able to swallow semi-liquid food
3
Able to swallow liquids only
4
Absolute dysphagia
Table 3 Demographic and clinical data of the patient population
Total
Ultraflex
Choostent
P-value
Patients
65
33
32
-
Male/female
43/22
23/10
20/12
0.5
Mean age (range)
67.5 (34-86)
66.8 (34-83)
68.3 (42-86)
0.6
Grade of dysphagia (mean ± SD)
3.4 ± 0.4
3.4 ± 0.3
3.5 ± 0.4
0.9
Diagnosis
Adenocarcinoma
31
16
15
0.9
Squamous cell carcinoma
20
11
9
0.8
Extrinsic compression
4
2
2
0.9
Anastomotic fistula
3
2
1
0.6
Anastomotic stricture
3
1
2
0.5
Anastomotic recurrence
2
1
1
0.9
Post-radiotherapy stricture
2
0
2
0.1
Site of lesion
Cervical
3
2
1
0.6
Upper thoracic
9
6
3
0.3
Middle thoracic
21
11
10
0.9
Lower thoracic
32
14
18
0.4
Tumor stage (n = 51)
III
19
12
7
0.6
IVA
17
8
9
0.7
IVB
15
7
8
0.5
Table 4 In-hospital characteristics and long-term outcome after stent placement
Ultraflex (n = 33)
Choostent (n = 32)
P-value
Duration of the procedure (min)
16 (12-35)
17 (13-27)
0.8
Median hospital stay (d)
2 (2-7)
2 (2-4)
0.7
Hospital mortality (%)
0
0
1.0
Hospital morbidity (%)
6.1 (2/33)
6.2 (2/32)
0.8
Pain score (scale 0-10)
6.3
4.8
0.2
Residual dysphagia (grade)
1.9 ± 0.3
2.1 ± 0.4
0.6
Mean survival (mo)
6.5 (1-19)
6 (3-26)
0.7
Table 5 Early and late complications after stent placement
n (%)
Ultraflex (n = 33)
Choostent (n = 32)
P-value
Abrasion of soft palate
1 (1.5)
1
0
0.3
Odynophagia
1 (1.5)
0
1
0.3
Malposition
1 (1.5)
0
1
0.3
Late distal migration
3 (4.6)
2
1
0.6
Persistent chest pain
3 (4.6)
2
1
0.6
Persistent hiccups
3 (4.6)
1
2
0.6
Gastroesophageal reflux
14 (22)
7
7
0.9
Food obstruction
5 (7.6)
2
3
0.6
Citation: Bona D, Laface L, Bonavina L, Abate E, Schaffer M, Ugenti I, Siboni S, Carrinola R. Covered nitinol stents for the treatment of esophageal strictures and leaks. World J Gastroenterol 2010; 16(18): 2260-2264