So H, et al. - The efficacy and safety of fully covered self-expanding metal stents (SEMSs) for malignant esophageal obstruction were investigated in this study. In palliation of malignant dysphagia, SEMSs were effective. Stent-related complications, however, ought to be borne in mind, especially in patients with gastric cancer with esophageal invasion and with larger width stents.

Methods

• The authors enrolled 119 patients with malignant dysphagia who underwent esophageal SEMS insertion with endoscopic assistance, between 2012 and 2015.
• They collected their demographics and clinical outcomes.
• They evaluated factors associated with stent-related complications and patient survival.
• They retrospectively analyzed all data.

Results

• In this study, the mean age of the 119 patients was 64.9 ± 11.6 years, and 25 (21%) were female.
• The authors observed squamous carcinoma in 75 patients (63.0%), majority of which were located in the lower thoracic esophagus (n = 42), followed by middle thoracic esophagus (n = 19) and upper esophagus (n = 10).
• At diagnosis, 80 patients (67.2%) underwent SEMS insertion.
• Technical and clinical success rates were 99.2 and 89.9%, respectively.
• Complications occurred in 47 patients (39.5%).
• Migration (36.3%) was the most common complication, followed by pain and obstruction.
• The median stent patency time was 145 days (95% confidence interval 55.19-234.81 days).
• Risk factors for complications were gastric cancer (odds ratio 3.51, 95% confidence interval 1.21-10.15; p=0.021) and a 20-mm-wide stent (odds ratio 2.922, 95% confidence interval 1.237-6.904; p=0.015).