Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 28, 2008; 14(24): 3919-3921
Published online Jun 28, 2008. doi: 10.3748/wjg.14.3919
A new approach to endoscopic treatment of tumors of the esophagogastric junction with individually designed self-expanding metal stents
Serhat Aymaz, Arno J Dormann
Serhat Aymaz, Arno J Dormann, Department of Medicine, Cologne City Hospital, Holweide, Neufelder Strasse 32, Cologne D-51067, Germany
Author contributions: Aymaz S and Dormann AJ contributed equally to this work.
Correspondence to: Serhat Aymaz, MD, MSc, Department of Medicine, Cologne City Hospital, Holweide, Neufelder Strasse 32, Cologne D-51067, Germany.
Telephone: +49-221-89072527
Fax: +49-221-89072388
Received: February 24, 2008
Revised: May 25, 2008
Accepted: May 31, 2008
Published online: June 28, 2008

The incidence of adenocarcinoma of the esophago-gastric junction is constantly increasing. Curative treatment is no longer possible at the time of diagnosis in more than 50% of patients with esophageal carcinoma, and palliative treatment focusing on eliminating dysphagia is required. Endoscopic therapy with stent implantation is an established method of achieving this. It can be carried out quickly, with a low rate of early complications, and leads to fast symptomatic improvement, assessed using the dysphagia score. The relatively high rate of late complications such as stent migration, hemorrhage, and gastroesophageal mucosal prolapse has led to recent debate on the role of metal stents in palliative therapy. We present here a new type of stent design for transcardial application, which is intended to prevent bleeding due to mechanical mucosal lesions caused by the distal end of the stent extending into the stomach. The further intention of this case report is to force the discussion on individually designed nitinol stents in special anatomic conditions.

Keywords: Esophagus cancer, Treatment, Palliative therapy, Endoscopic therapy, Stent, Cardiac cancer