Palliative management of irresectable carcinoma esophagus using self expandable metallic stent (SEMS).

Objective: To evaluate the symptomatic relief of dysphagia after stenting in patients with carcinoma esophagus

Methods: A prospective non randomized descriptive study was conducted at Surgical Unit 4, Civil Hospital Karachi, Pakistan over a period of 1 year, from August 2006 to July 2007. A total of 41 patients with biopsy proven carcinoma esophagus having irresectable disease on the basis of CT scan or poor risk for major surgery were included in the study. Self expandable metallic stents were placed under fluoroscopic guidance in all the patients. Follow up was done weekly for 1 month and monthly for 6 months or till death of the patient. Data was analyzed using SPSS version 11.

Results: Age of the study population ranged from 25-80 years with mean age of 51.49 +/- 14.25 years. Male to female ratio was 1.15:1. Preoperative dysphagia for solids was seen in 4.9%, for semi solids in 31.7%, and for liquids in 63.4%. 80.5% of patients had squamous cell carcinoma and 19.5% of patients had adenocarcinoma. Dilatation prior to stenting was done up to 12.8 mm in 65.9%. Complete relief of dysphagia was seen in 73%. No procedure related mortality was seen in our study. Overall complication rate was 29.2%.

Conclusion: SEMS is an effective method for the relief of dysphagia in patients with irresectable carcinoma esophagus.