Endoscopic esophageal stenting as a method of selecting and eliminating dysphagia syndrome in esophageal stenosis

Abstract

To assess of our study was to analyze the experience of using esophageal stents in dysphagia syndrome. The main questions to which they wanted to get an answer: the formulation of the main indications and contraindications for esophageal stenting; evaluation of the efficiency and feasibility of esophageal stenting with self-expanding metal stents in incurable patients. At the General Surgery Department of the S. M. Kirov Military Medical Academy performed stenting in 78 patients for malignant neoplastic processes and in 2 patients with benign esophageal stricture, who underwent treatment from 2007 to 2020. The patient group included 61 men (76.3%) and 19 women (23.7%). 69 people applied for grade III–IV dysphagia, 6 had tracheo-esophageal fistulas, and 3 had esophageal-pleural fistulas formed during tumor decay, 2 patients were treated for esophageal burn stricture. The stents of the Korean company «M. I. Tech». Installation were performed with short, small diameter endoscopic delivery systems. The onset of feeding, as a rule, began on the next day with satisfactory standing and adequate expansion of the stent, and no displacement. The patient could leave the hospital on the same day. Meals began with the use of water and liquid food with a gradual expansion of the density and consistency of the food. The minimally invasive method for eliminating dysphagia in inaccurate patients is esophageal stenting with self-expanding stents. Esophageal stenting has fewer complications than other invasive surgical techniques for resolving dysphagia. The advantage of palliative treatment of tumor stenoses and fistulas by stenting is to reduce the manifestations of dysphagia, improve the quality and increase the life expectancy of patients (3 figs, bibliography: 15 refs).

Keywords

esophageal cancer / esophageal stricture / stenting / tracheoesophageal fistula

References

[1] Korolev M. P., Fedotov L. E., Smirnov A. A. Endoprosthetics with self-expanding metal stents in stenotic diseases of the esophagus. Vestnik khirurgii imeni I. I. Grekova. 2010; 169 (1): 58–64. Russian (Королев М. П., Федотов Л. Е., Смирнов А. А. Эндопротезирование саморасширяющимися металлическими стентами при стенотических заболеваниях пищевода. Вестник хирургии имени И. И. Грекова. 2010; 169 (1): 58–64).

[2] Lazarev A. F., Fokeev S. D. A comparative analysis of radical treatment of esophageal cancer. Rossiyskiy onkologicheskiy zhurnal. 2006; 2: 35–7. Russian (Лазарев А. Ф., Фокеев С. Д. Сравнительный анализ радикального лечения рака пищевода. Российский онкологический журнал. 2006; 2: 35–7).

[3] Roman L. D., Kotiv B. N., Bisenkov L. N., Shostka K. G., Kostyuk I. P. A Comparative analysis of radical treatment of esophageal cancer. Rossiyskiy onkologicheskiy zhurnal. 2009; 55 (1): 56–9. Russian (Роман Л. Д., Котив Б. Н., Бисенков Л. Н., Шостка К. Г., Костюк И. П. Паллиативные вмешательства в хирургическом лечении рака грудного отдела пищевода. Российский онкологический журнал. 2009; 55 (1): 56–9).

[4] van Boeckel P. G., Sijbring A., Vleggaar F. P., Siersema P. D. Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus. Aliment. Pharmacol. Ther. 2011; 33 (12): 1292–301. DOI: 10.1111/j.1365-2036.2011.04663.x

[5] Gallinger Yu. I., Gojello E. A. Endoscopic treatment of esophageal anastomosis strictures. Moscow: Profile Publisher; 2006. 152. Russian (Галлингер Ю. И., Годжелло Э. А. Эндоскопическое лечение стриктур пищеводного анастомоза. М.: Профиль; 2006. 152).

[6] Skvortsov M. B. Esophageal cancer: surgical treatment. The Siberian Medical Journal. 2011; 4: 21–30. Russian (Скворцов М. Б. Рак пищевода: хирургическое лечение. Сибирский медицинский журнал. 2011; 4: 21–30).

[7] Khayruddinov R. V. Modern principles of diagnostics and surgical treatment of esophageal cancer. Vestnik khirurgii imeni I. I. Grekova. 2006; 165 (3): 48–51. Russian (Хайруддинов Р. В. Современные принципы диагностики и хирургического лечения рака пищевода. Вестник хирургии имени И. И. Грекова. 2006; 165 (3): 48–51).

[8] Cook M. B., Wild C. P., Everett S. M., Hardie L. J., Bani-Hani K. E., Martin I. G., Forman D. Risk of mortality and cancer incidence in Barrett,s esophagus. Cancer Epidemiol. Biomarkers Prev. 2007; 16 (10): 2090–6. DOI: 10.1158/1055-9965.EPI-07-0432

[9] Ott C., Ratiu N., Endlicher E., Rath H. C., Gelbmann C. M., Schölmerich J., Kullmann F. Self-expanding Polyflex plastic stents in esophageal disease: various indications, complications, and outcomes. Surg. Endosc. 2007; 21 (6): 889–96. DOI: 10.1007/s00464-006-9067-x

[10] Saito Y., Tanaka T., Andoh A., Minematsu H., Hata K., Tsujikawa T., Nitta N., Murata K., Fujiyama Y. Novel biodegradable stents for benign esophageal strictures following endoscopic submucosal dissection. Dig. Dis. Sci. 2008; 53 (2): 330–3. DOI: 10.1007/s10620-007-9873-6

[11] Ishchenko A. A., Belonogov A. V., Baryshnikov E. S., Dimov A. A. Endosurgical methods for restoring enteral nutrition in inoperable esophageal cancer. Siberian Journal of Oncology. 2008; 1: 62–3. Russian (Ищенко А.А., Белоногов А. В., Барышников Е. С, Димов А. А. Эндохирургические способы восстановления энтерального питания при неоперабельном раке пищевода. Сибирский онкологический журнал. 2008; 1: 62–3).

[12] Klimashevich A. V. The possibility of treatment of continuously Recurrent esophageal strictures by stenting. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskiye nauki. 2011; 3: 81–8. Russian (Климашевич А. В. Возможность лечения непрерывно рецидивирующих стриктур пищевода методом стентирования. Известия высших учебных заведений. Поволжский регион. Медицинские науки. 2011; 3: 81–8).

[13] Klimashevich A. V., Nikolsky V. I., Bogonina O. V., Antonov V. V. Prevention and treatment of cicatricial strictures of the esophagus. Fundamental’nyye issledovaniya. 2012; 4–1: 63–8. Russian (Климашевич А. В., Никольский В. И., Богонина О. В., Антонов В. В. Профилактика и лечение рубцовых стриктур пищевода. Фундаментальные исследования. 2012; 4–1: 63–8).

[14] Eloubeidi M. A., Talreja J. P., Lopes T. L., Al-Awabdy B. S., Shami V. M., Kahaleh M. Success and complications associated with placement of fully covered removable self-expandable metal stents for benign esophageal diseases (with videos). Gastrointest. Endosc. 2011; 73 (4): 673–81. DOI: 10.1016/j.gie.2010.11.014

[15] Mosca F., Consoli A., Stracqualursi A., Persi A., Portale T. R. Comparative retrospective study on the use of plastic prostheses and self-expanding metal stents in the palliative treatment of malignant strictures of the esophagus and cardia. Dis. Esophagus. 2003; 16 (2): 119–25. DOI: 10.1046/j.1442-2050.2003.00308.x

RIGHTS & PERMISSIONS

Belevich V.L., Brednev A.O., Kurlova O.G.