The oesophageal metallic stenting – A new palliative treatment of malignant oesophageal stenoses and broncho-oesophageal fistulas

Recently the oesophageal metallic stenting has become a new palliative treatment of inoperable malignant stenoses and broncho-oesophageal fistulas. Our initial experiences in this field are demonstrating.

Patients and method: 5 patients (49–73 years) were treated with self-expanding metallic oesophageal stents from March 2003. – Jan. 2004. Two of them had stenotising oesophageal carcinoma, 3 patients had malignant stenosis because of pulmonary or mediastinal tumour compression. 2 of the patients had broncho-oesophageal fistula.

Results: The oesophageal stenosis was dilated in 4 patients with Bougie technique to 9–11,8mm before oesophageal stenting. The length of the placed self-expanding stents was 9–15cm with a 7–12cm covered part, and expanded to 17–18mm. The only early complication observed immediately after stenting was a strong chest pain requiring opiate analgetics in one case. In another patient the stent got occluded by food in 5 and 7 months after the implantation of the endoprothesis, which could be resolved endoscopically. 2 patients died in 5 and 6 weeks after stenting, 3 patients had been living for 4, 10 and 33 weeks, respectively.

Conclusions: The metallic oesophageal stenting is a suitable treatment option for malignant oesophageal stenoses and broncho-oesophageal fistulas, it enables adequate alimentation, promotes healing of aspiration pneumonia, improves the general condition and quality of life. The procedure seems to be safe and simple in the treatment of inoperable malignant oesophageal stenoses.