Background: Malignant dysphagia due to esophagogastric cancer is associated with poor overall prognosis. Placements of self-expandable metal stents or plastic tubes are established methods as palliative treatment opti...Background: Malignant dysphagia due to esophagogastric cancer is associated with poor overall prognosis. Placements of self-expandable metal stents or plastic tubes are established methods as palliative treatment options. As an alternative and/or complementary therapy, radiologic techniques (external beam radiation/brachy therapy) and locally endoscopic techniques (laser, APC-beamer, PDT) are often used. Study and Goals: Retrospective trial of 153 patients treated in our department between 1993 and 2001. Forty-five patients received a plastic tube ( Group A) and 108 patients were treated with metal stents (Group B). Both groups were compared for improvement of dysphagia score, survival, recurrent dysphagia and complications. Results: Stent placement was successful in 41 of 45 (93%) pa tients of Group A and 107 of 108 (99%) of Group B. The median dysphagia score i mproved significantly in Group A (from 3.03 to 1.55, P = 0.010) and Group B (fro m 2.77 to 1.44, P = 0.009). Recurrent dysphagia was noted in 12 of 45 (27%) pat ients of Group A and 27 of 108 (25%) patients of Group B. Median survival time after stent insertion was 78 days (Group A) and 113 days (Group B). Overall comp lications occurred in 15 of 45 (33%) patients of Group A and 28 of 108 (26%) p atients of Group B. However, significantly (P = 0.05) more major complications w ere seen in Group A than in Group B (22%vs. 9%). Conclusions: Our results indi cate a marginal clinical benefit for metal stents versus plastic tubes in malign ant dysphagia in the long run. However, metal stents seem to be safer and associ ated with a prolonged improvement of dysphagia score.展开更多
文摘Background: Malignant dysphagia due to esophagogastric cancer is associated with poor overall prognosis. Placements of self-expandable metal stents or plastic tubes are established methods as palliative treatment options. As an alternative and/or complementary therapy, radiologic techniques (external beam radiation/brachy therapy) and locally endoscopic techniques (laser, APC-beamer, PDT) are often used. Study and Goals: Retrospective trial of 153 patients treated in our department between 1993 and 2001. Forty-five patients received a plastic tube ( Group A) and 108 patients were treated with metal stents (Group B). Both groups were compared for improvement of dysphagia score, survival, recurrent dysphagia and complications. Results: Stent placement was successful in 41 of 45 (93%) pa tients of Group A and 107 of 108 (99%) of Group B. The median dysphagia score i mproved significantly in Group A (from 3.03 to 1.55, P = 0.010) and Group B (fro m 2.77 to 1.44, P = 0.009). Recurrent dysphagia was noted in 12 of 45 (27%) pat ients of Group A and 27 of 108 (25%) patients of Group B. Median survival time after stent insertion was 78 days (Group A) and 113 days (Group B). Overall comp lications occurred in 15 of 45 (33%) patients of Group A and 28 of 108 (26%) p atients of Group B. However, significantly (P = 0.05) more major complications w ere seen in Group A than in Group B (22%vs. 9%). Conclusions: Our results indi cate a marginal clinical benefit for metal stents versus plastic tubes in malign ant dysphagia in the long run. However, metal stents seem to be safer and associ ated with a prolonged improvement of dysphagia score.
