TY - JOUR
T1 - Use of the 25 mm flanged esophageal z stent for Malignant dysphagia
T2 - A prospective multicenter trial
AU - Kozarek, Richard A.
AU - Raltz, Shirley
AU - Marcon, Norman
AU - Kortan, Paul
AU - Haber, Gregory
AU - Lightdale, Charles
AU - Stevens, Peter
AU - Lehman, Glen
AU - Rex, Douglas
AU - Benjamin, Stanley
AU - Fleischer, David
AU - Bashir, Roshan
AU - Fry, Steven
AU - Waxman, Irving
AU - Benson, Jay
AU - Polio, John
N1 - Publisher Copyright:
© 1997 by the American Society for Gastrointestinal Endoscopy.
PY - 1997
Y1 - 1997
N2 - Background: An initial multicenter study using a 21 mm flanged esophageal Z stent demonstrated excellent palliation but an 11% immediate complication rate at placement and a 27% migration rate at 1 month. This North American multicenter trial prospectively studied a 25 mm flanged Z stent to define its palliative ability and whether the increased diameter affected placement or migration problems. Methods: Fifty patients who had esophageal Z stents at seven university or regional referral hospitals were prospectively studied. Indications for prosthesis placement, previous therapy, patient demographics, incidence of concomitant tracheoesophageal fistula, and degree of dysphagia were defined, as were procedural and subsequent stent-related problems, survival times, the ability to occlude a tracheoesophageal fistula, and subsequent degree of dysphagia. Results: Twenty-four patients had infiltrating malignancy (16 exophytic and 10 extrinsic), 9 of whom had concomitant tracheoesophageal fistulas. Ten patients (20%) had misplaced stents requiring retrieval and replacement, 12 patients (24%) had subsequent stent-related problems including exsanguination (2), aspiration (3), tumor overgrowth (3), and postplacement migration (4) (8%). There was statistically significant improvement in prestent versus poststent dysphagia and two thirds of patients had complete occlusion of their tracheoesophageal fistula. Conclusions: Redesign of the esophageal Z stent has decreased the migration rate without increasing placement or subsequent erosion problems. Its efficacy appears comparable to the currently marketed Z stent for the palliation of malignant dysphagia and occlusion of tracheoesophageal fistula.
AB - Background: An initial multicenter study using a 21 mm flanged esophageal Z stent demonstrated excellent palliation but an 11% immediate complication rate at placement and a 27% migration rate at 1 month. This North American multicenter trial prospectively studied a 25 mm flanged Z stent to define its palliative ability and whether the increased diameter affected placement or migration problems. Methods: Fifty patients who had esophageal Z stents at seven university or regional referral hospitals were prospectively studied. Indications for prosthesis placement, previous therapy, patient demographics, incidence of concomitant tracheoesophageal fistula, and degree of dysphagia were defined, as were procedural and subsequent stent-related problems, survival times, the ability to occlude a tracheoesophageal fistula, and subsequent degree of dysphagia. Results: Twenty-four patients had infiltrating malignancy (16 exophytic and 10 extrinsic), 9 of whom had concomitant tracheoesophageal fistulas. Ten patients (20%) had misplaced stents requiring retrieval and replacement, 12 patients (24%) had subsequent stent-related problems including exsanguination (2), aspiration (3), tumor overgrowth (3), and postplacement migration (4) (8%). There was statistically significant improvement in prestent versus poststent dysphagia and two thirds of patients had complete occlusion of their tracheoesophageal fistula. Conclusions: Redesign of the esophageal Z stent has decreased the migration rate without increasing placement or subsequent erosion problems. Its efficacy appears comparable to the currently marketed Z stent for the palliation of malignant dysphagia and occlusion of tracheoesophageal fistula.
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U2 - 10.1016/S0016-5107(97)70065-8
DO - 10.1016/S0016-5107(97)70065-8
M3 - Article
C2 - 9283867
AN - SCOPUS:0030865869
SN - 0016-5107
VL - 46
SP - 156
EP - 160
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 2
ER -