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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2006; 12(13): 2103-2108
Published online Apr 7, 2006. doi: 10.3748/wjg.v12.i13.2103
Endoprosthesis implantation at the pharyngo-esophageal level: Problems, limitations and challenges
Efthimios Eleftheriadis, Katerina Kotzampassi
Efthimios Eleftheriadis, Katerina Kotzampassi, Department of Surgery, University of Thessaloniki Medical School, Thessaloniki, Greece
Author contributions: All authors contributed equally to the work.
Correspondence to: Efthimios Eleftheriadis, PO Box 185C, Plagiari, Thessaloniki, GR-57500, Greece. elemakis@med.auth.gr
Telephone: +30-2310-993496
Received: September 8, 2005
Revised: October 15, 2005
Accepted: October 26, 2005
Published online: April 7, 2006
Abstract

AIM: To present our experience with endoscopic placement of an esophageal endoprosthesis in 19 patients.

METHODS: A retrospective evaluation was made for the use of 19 stents positioned at the level of the cervical esophagus: 11 for malignant tumours (7 causing obstruction, 4 complicated by an esophago -tracheal or -cutaneous fistula), and 8 for an acquired benign tracheo-esophageal fistula due to prolonged intubation. The covered Ultraflex stent was used in all cases except two. These two patients had an esophagocutaneous fistula following laryngectomy and a Flamingo Wall stent was used.

RESULTS: Stent implantation was technically successful in all patients. Dysphagia score was improved from 3 to 2 in stenosis patients, while sealing of the fistula was achieved in all cases. The median hospital stay was 3 d for malignant tumour patients and 13.5 d for esophagocutaneous fistula patients. One Ultraflex stent and two Flamingo Wall stents were easily removed 33 d and 3 months respectively after implantation when the fistulas had totally occluded.

CONCLUSION: Endoprosthesis implantation for malignancy and/or fistula of malignant or benign origin at the level of the cervical esophagus is an easy, well tolerated, safe and effective procedure with no complications or mortality.

Keywords: Cervical endoprosthesis, Pharyngo-esophageal stenosis, Dysphagia, Esophageal carcinoma, Esophagotracheal fistula