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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

ANSELMI M, Mario; GEMMATO P, Ana María  y  RODRIGUEZ D, Antonio. Use of Choostent prosthetic device for palliation of dysphagia secondary to esophageal cancer. Rev Chil Cir [online]. 2012, vol.64, n.6, pp.546-554. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262012000600008.

Background: Esophageal cancer causes disabling dysphagia and swallowing problems. Aim: To prospectively analyze the outcome of the insertion of a covered self-expanding metallic Choostent type prosthesis as a method of palliation of dysphagia, esophageal fistula or leak secondary to malignant disease of the esophagus or cardia. Material and Methods: A total of 30 consecutive patients aged 75 ± 8.8 years (63% males) with malignant disease of the esophagus or cardia were studied. Results: In 27 patients (90%) the stenosis was located in the esophagus, in two (6.7%) at the gastroesophageal junction and in one (3.3%) at the esophago - jejunal anastomosis due to tumor recurrence. In 24 cases (80%), the indication of the prosthesis was dysphagia, in three (10%) the presence of a tracheo-esophageal fistula and in the remaining three (10%), the suspicion of a perforation. Patients were followed until death. The prosthesis was inserted without incidents in 29 patients (96.6%). One patient had a pneumomediastinum, which evolved favorably. Dysphagia subsided in all patients. Early evolution was satisfactory in 12 patients (66.7%). The most common early complication was a transient chest pain in 3 cases (10%). Four patients (13.3%) died within 30 days post procedure. Of the remaining 26 patients, 14 (53.8%) had late complications (recurrence of dysphagia in 42% and hemorrhage in 11%). The mean interval between stent insertion and death was 169 ± 142.5 days. Conclusions: The Choostent esophageal prosthesis improves dysphagia immediately and safely. However, its use is associated with a high rate of late complications, directly related to prosthetic dysfunction.

Palabras clave : Esophageal cancer; dysphagia; self-expanding metal stents.

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