Palliation of malignant esophageal obstruction and fistulas with self expandable metallic stents

Table 1 Characteristics of restented patients

Age (yr)	Sex	Reason for restenting	Tumor location (stage)	Stenosis location	Dilatation	Stent type
62	M	Proximal overgrowth	Gastric (T4)	Distal	No	6 cm, 20 mm CVRD
52	M	Proximal overgrowth	Lung Tm	Middle	No	6 cm, 20 mm CVRD
54	M	Proximal overgrowth	Gastric (T4)	Distal	APC	6 cm, 20 mm CVRD
71	M	Proximal overgrowth	Esophagus (T4)	Distal	No	6 cm, 20 mm CVRD
75	M	Migration	Lung Tm	Middle	No	10 cm, 20 mm CVRD
53	M	Proximal overgrowth	Esophagus (T4)	Proximal	No	6 cm, 18 mm CVRD
64	M	Migration	Esophagus (T3)	Middle	No	10 cm, 18 mm CVRD
67	M	Migration	Esophagus (T4)	Distal	No	10 cm, 20 mm UCVRD
55	F	Proximal overgrowth	Gastric (T4)	Distal	No	15 cm, 20 mm CVRD
49	F	Migration	Esophagus (T4)	Distal	No	6 cm, 20 mm CVRD

CVRD: Covered; UCVRD: Uncovered; APC: Argon plasma coagulation.

Table 2 Patient demographics

	n (%)
Total No. of patients	90
Mean age (yr, range)	61.57 (38-85)
Male/female	65/25 (72.2/27.8)
Present illness
Esophagus carcinoma	54 (60.0)
Squamous cell carcinoma	47 (52.2)
Adenocarcinoma	7 (7.7)
Gastric carcinoma (and cardiac)	20 (22.2)
Lung carcinoma	16 (17.7)
Location of obstruction
Proximal	5 (5.6)
Middle	31 (34.4)
Distal	54 (60.0)
Restenting	10 (11.1)

Table 3 Outcome of published series of self-expandable metallic stent insertion: with or without fluoroscopy for self-expandable metallic stent insertion

Series	n	Dilation rate (%)	Stents uncovered	Perforation rate (%)	Migration rate (%)	Overgrowth rate (%)	Ingrowth rate (%)	Reintervention rate (%)	Median survival (d)
Present series	90	30.0	15/85	0	4.4	6.6	3.3	15.5	134
Wilkes et al[5]1	98	8	95/5	0	3.1	25.5	-	39.8	100
Adam et al[6]	42	100	45/55	0	19	2.3	9.5	36	53
Knyrim et al[7]2	21	0	100/0	0	0	9.5	14.2	3.8	167
Sarper et al[8]	41	100	19/81	4.9	2.4	2.4	2.4	-	94
Siersema et al[9]	100	7	0/100	6	13	10	0	49	109
Christie et al[10]	100	77	76/24	1	8.7	4	29.1	51	-
Wengrower et al[11]3	81	-	100/0	3.6	5.95	2.4	0	-	120
De Palma et al[12]2	19	0	100/0	0	0	0	10.5	-	198
Kozarek et al[13]	38	100	5/95	3	18.4	23.6	5.2	80	90
White et al[14]1	70	100	57/43	2.8	0	1.4	2.8	-	-
Maroju et al[15]1	30	-	9/91	0	3	7	10	-	161

¹Stent was placed under direct visualization in the study; ²Study of self-expandable metallic stent (SEMS) vs plastic esophageal prostheses treatment, but only data from SEMS arm was included; ³Only esophacoil stents were used.