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BIBTEX RIS

Adverse events of self-expandable esophageal metallic stents in patients with long-term survival from advanced malignant disease

2016; Elsevier BV; Volume: 86; Issue: 2 Linguagem: Inglês

10.1016/j.gie.2016.12.017

1097-6779

Vitor Sousa Medeiros, Bruno da Costa Martins, Luciano Lenz, Maria Sylvia I. Ribeiro, Gustavo Andrade de Paulo, Marcelo Simas de Lima, Adriana V. Safatle‐Ribeiro, Fabio Shighuehissa Kawaguti, Caterina Pennacchi, Sebastian Geiger, Victor R. Bastos, Ulysses Ribeiro, Rubens Antônio Aissar Sallum, Fauze Maluf‐Filho,

Tracheal and airway disorders

Self-expandable metallic stents are considered the best palliative treatment of dysphagia for patients with advanced esophageal cancer. Adverse events (AEs) are a major concern, especially in patients with better prognosis and longer survival. The present study aimed to evaluate the AEs of patients who survived longer than 6 months with esophageal stents in place.This is a retrospective analysis of a prospectively collected database including all patients submitted to esophageal stent placement for the palliation of malignant diseases during the period from February 2009 to February 2014 at a tertiary care academic center who had stents longer than 6 months.Sixty-three patients were included. Mean follow-up was 10.7 months. Clinical success was achieved in all patients, and the median stent patency was 7.1 months. AEs occurred in 40 patients (63.5%), totaling 62 AEs (mean, 1.5 AEs per patient). Endoscopic management of AEs was successful in 84.5% of cases, with a mean of 1.6 reinterventions per patient. The univariate analysis revealed that performance status, age, and post-stent radiotherapy presented a trend to higher risk of AEs. The multivariate analysis revealed that only performance status was associated with AEs (P = .025; hazard ratio, 4.1).AEs are common in patients with long-term esophageal stenting for malignancy. However, AEs were not related to higher mortality rate, and most AEs could be successfully managed by endoscopy. Only performance status was a risk factor for AEs. Our data suggest that metallic stenting is a valid option for the treatment of malignant esophageal conditions, even when survival longer than 6 months is expected.