TREATMENT OF MALIGNANT DYSPHAGIA WITH NITINOL STENTS

Self-expanding nitinol stents were used in 22 patients for palliative treatment of malignant esophagogastric strictures. All patients but 5 were men (age range 47-75 year). The strictures were caused by squamous cell carcinoma (n=12), adeno-carcinoma (n=8), and recurrent anastomotic carcinoma (n=2). No technical failure or procedural complications occurred. After the procedure, the severity of dysphagia decreased at least one grade in all patients of 22 (32%). Four of these patients were treated with additional stents, and in 3 patients, due to refusal, only balloon dilations were performed, which caused temporary relief. Tumor ingrowth into the stent was noted from 10 days to 7 months (mean 3 months). This seems to be a disadvantage of nitinol stents. At the end of the study 10 patients had died dead with a mean survival of 3 months (range 1 week to 6 months) and 12 patients had died dead with a mean survival of 3 months (range 1 week to 6 months) and 12 patients were still alive with a mean follow-up of 4 months (range 1-8 months). It is concluded that nitinol stents provide satisfactory palliation in patients with malignant dysphagia with neglectable procedural morbidity an mortality rates.