Less than 50% of patients with esophageal carcinoma are suitable for surgery at the time of diagnosis. Most of these patients present with locally advanced or metastatic disease and/or significant comorbidities. In such circumstances, the only therapeutic option is palliative care to treat dysphagia and prevent respiratory complications secondary to aspiration. Self-expanding metal stents have been proven effective for palliation of dysphagia in patients with esophageal carcinoma, tracheo-esophageal fistulas or anastomotic leaks.
A brief article published on May 14, 2010 in the World Journal of Gastroenterology reports the experience of an Italian high-volume center for esophageal diseases. Dr. Davide Bona, Professor Luigi Bonavina and his colleagues at University of Milan Medical School, IRCCS Policlinico San Donato, investigated the effectiveness, safety and outcome of two most popular esophageal metal stents in patients with dysphagia.
The study confirmed that esophageal stents provided good palliation of dysphagia in patients with inoperable esophageal carcinoma. In these patients, metal stents allowed a better quality of life during chemotherapy administration and were safely removed without compromising the subsequent surgical intervention. Good results were also obtained in the conservative management of anastomotic leaks. The results showed that both types of stents used for the study have similar outcomes and that they can both be used as "bridging" therapy before surgical resection.
Reference: Bona D, Laface L, Bonavina L, Abate E, Schaffer M, Ugenti I, Siboni S, Carrinola R. Covered nitinol stents for the treatment of esophageal strictures and leaks. World J Gastroenterol 2010; 16(18): 2260-2264 http://www.wjgnet.com/1007-9327/full/v16/i18/2260.htm
Correspondence to: Luigi Bonavina, Professor, Department of Medical and Surgical Sciences, Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, 20100 Milano, Italy. luigi.bonavina@unimi.it Telephone: +39-2-52774621 Fax: +39-2-52774622
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology