Objective: Esophageal stent placement is vital for alleviating dysphagia, enabling immediate relief and smoother food passage. This minimally invasive procedure reduces hospital stays, enhancing quality of life and offering a safer option for high-risk patients. Effective in both malignant and benign cases, stents are cost-efficient and require skilled professionals for optimal outcomes. This study examines outcomes of various stent types in 183 esophageal cancer patients, evaluating efficacy, safety, and impact on quality of life.
Methods: Between January 2022 and December 2022, 183 patients with esophageal cancer were enrolled from three tertiary health care facilities and divided into three groups based on the type of esophageal stent used: self-expanding metallic stents (SEMS, n = 84), self-expanding plastic stents (SEPS, n = 61), and fully covered self-expanding metallic stents (FCSEMS, n = 38). Stent placement was performed under endoscopic guidance. Follow-up with endoscopic assessments were conducted at 1 week, 1 month, 3 months, and 6 months post-stent placement to evaluate stent patency, dysphagia relief, and complications.
Results: The technical success rates for stent placement were high across all groups, with SEMS at 96.4%, SEPS at 95.1%, and FCSEMS at 97.4%. Immediate dysphagia relief was achieved in 87.4% of patients across the three stent types. FCSEMS demonstrated a significantly longer median stent patency duration (8.0 months) compared to SEMS (6.3 months) and SEPS (5.6 months). The SEPS group experienced a higher incidence of stent migration (13.1%) compared to SEMS (8.3%) and FCSEMS (6.5%) groups. Post-interventional complications were documented in 18.0% of patients, with tissue overgrowth (8.7%) and stent migration (6.0%) being the most common. Overall survival rates at 6 months were comparable across the three groups. Notably, FCSEMS displayed superior patency (p < 0.05), suggesting its potential preference in specific cases. The study confirms the effectiveness of stent placement in enhancing patient comfort and quality of life.
Conclusion: This study underscores the efficacy of esophageal stent placement as a crucial palliative intervention for dysphagia in esophageal cancer patients. Fully covered self-expanding metallic stents (FCSEMS) exhibited notable advantages, demonstrating prolonged stent patency compared to other types. However, careful consideration is warranted for patients in the self-expanding plastic stents (SEPS) group due to a higher incidence of stent migration. The high technical success rates and immediate dysphagia relief affirm the proficiency and immediate positive impact of this procedure. Overall, this research highlights the importance of tailored stent selection and ongoing investigation to optimize outcomes for esophageal cancer patients.

Before & After FCSEMS

SEPS vs SEMS vs FCSEMS

Ahmad Al Shihabi

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