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Small caliber covered self-expanding metal stents in the management of malignant dysphagia.

Title: Small caliber covered self-expanding metal stents in the management of malignant dysphagia.
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Name(s): Kucera, Stephen, author
Barthel, James, author
Klapman, Jason, author
Shridhar, Ravi, author
Hoffe, Sarah, author
Harris, Cynthia, author
Almhanna, Khaldoun, author
Meredith, Kenneth, author
Type of Resource: text
Genre: Journal Article
Text
Date Issued: 2016-06-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Use of large caliber [≥18 mm body diameter (BD)] self-expanding metal stents (SEMS) for management of malignant dysphasia is associated with substantial adverse event (AE) and mortality rates (MRs). We sought to determine dysphagia response, stent migration rates, and AE and MRs, for small caliber covered SEMS (sccSEMS) with BDs between 10-16 mm in malignant dysphagia. Thirty-one patients underwent direct endoscopic placement of 50 sccSEMS between January 2008 and March 2011. Patients were monitored for change in dysphagia score (DS), stent migration, AEs, and death through May 2011. DS improved in 30 of 31 patients (97%). The median DS decreased from 3 to 2 (P<0.0001). The median effective duration of first sccSEMS placement was 116 (95% CI: 75-196) days. Major and minor AE rates were 6.5% and 19.4% respectively. No stent related deaths were encountered. The overall migration rate was 36% (18/50). The anticipated migration rate was 45.7% (16/35) and the unanticipated migration rate was 13.3% (2/15) (P=0.052). Positive effective clinical outcome occurred in 93.5% (29/31) of cases. In malignant dysphagia, direct endoscopic sccSEMS placement provided acceptable dysphagia control and migration rates with substantial reductions in stent related AEs and MRs compared to those reported for large caliber SEMS.
Identifier: FSU_pmch_27284474 (IID), 10.21037/jgo.2015.12.03 (DOI), PMC4880758 (PMCID), 27284474 (RID), 27284474 (EID), jgo-07-03-411 (PII)
Keywords: Esophageal stent, Dysphagia, Esophageal cancer
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880758.
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_pmch_27284474
Owner Institution: FSU
Is Part Of: Journal of gastrointestinal oncology.
2078-6891
Issue: iss. 3, vol. 7

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Kucera, S., Barthel, J., Klapman, J., Shridhar, R., Hoffe, S., Harris, C., … Meredith, K. (2016). Small caliber covered self-expanding metal stents in the management of malignant dysphagia. Journal Of Gastrointestinal Oncology. Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_27284474