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Medeiros, Vitor Sousa, MD; Martins, Bruno Costa, MD; Lenz, Luciano, MD; Ribeiro, Maria Sylvia Ierardi, MD; de Paulo, Gustavo Andrade, MD; Lima, Marcelo Simas, MD; Safatle-Ribeiro, Adriana Vaz, PhD; Kawaguti, Fabio Shighuehissa, MD; Pennacchi, Caterina, MD; Geiger, Sebastian N., MD; Bastos, Victor R., MD; Ribeiro-Junior, Ulysses, PhD; Sallum, Rubens A., PhD; Maluf-Filho, Fauze, PhD
Gastrointestinal endoscopy, 08/2017, Letnik: 86, Številka: 2Journal Article
Background and Aims Self-expandable metallic stents are considered the best palliative treatment of dysphagia for patients with advanced esophageal cancer. Adverse events (AEs) are a major concern, especially in patients with better prognosis and longer survival. The present study aimed to evaluate the AEs of patients who survived longer than 6 months with esophageal stents in place. Methods This is a retrospective analysis of a prospectively collected database including all patients submitted to esophageal stent placement for the palliation of malignant diseases during the period from February 2009 to February 2014 at a tertiary care academic center who had stents longer than 6 months. Results Sixty-three patients were included. Mean follow-up was 10.7 months. Clinical success was achieved in all patients, and the median stent patency was 7.1 months. AEs occurred in 40 patients (63.5%), totaling 62 AEs (mean, 1.5 AEs per patient). Endoscopic management of AEs was successful in 84.5% of cases, with a mean of 1.6 reinterventions per patient. The univariate analysis revealed that performance status, age, and post-stent radiotherapy presented a trend to higher risk of AEs. The multivariate analysis revealed that only performance status was associated with AEs ( P = .025; hazard ratio, 4.1). Conclusions AEs are common in patients with long-term esophageal stenting for malignancy. However, AEs were not related to higher mortality rate, and most AEs could be successfully managed by endoscopy. Only performance status was a risk factor for AEs. Our data suggest that metallic stenting is a valid option for the treatment of malignant esophageal conditions, even when survival longer than 6 months is expected.
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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