Palliation of malignant esophageal obstruction and fistulas with covered self expandable metallic stents: assessment of a simple fluroscopic method.

PURPOSE To introduce a convenient, quick and effective way to place self-expandable metal stents (SEMSs) to relieve dysphagia and fistula caused by esophageal carcinoma. MATERIALS AND METHODS A consecutive series of 36 patients (25 men, 11 women), aged 38-82 years (median, 52.7 years) underwent stent placement using a 7F long sheath of 55 cm and fully covered SEMS under local anesthesia with fluoroscopic control. RESULTS Stent placement was successful in all patients. Swallowing improved from mean dysphagia score 3.44 ± 0.50 to score 0.69 ± 0.71 (P = 0.000). There were no clinically significant complications during and after the deployment of stents. Migration was noted in 4 patients. Restenting was needed in 3 patients. Removal was needed in 2 patients. Mean survival following stenting was 134.14 d. CONCLUSIONS SEMSs provide rapid, safe and effective relief of dysphagia and fistula. Using the 7F long sheath of 55 cm could make the procedure easy, quick and safe.