Yerlan Abdirashev, MD, Nurken Abdiyev, Sholpan Izmagambetova, MD, Amir Uzhakhov, MD. JSC “National Scientific center of surgery named after A.N. Syzganov’s”
Aims: The severe and complicated malignant stenosis of UGI show up a difficult problem. The purpose is retrospective analysis of SEMS inserting to UGI cancer obstruction.
Methods: From 2014 to 2018 we analyzed of 69 cases of inoperable cancer esophagus and GOO. 53 cases (77.3 %) of stenosis caused by esophageal cancer (EC) and EJ, 16 (22.7 %) patients had malignant GOO. The AC of esophagus and gastric was diagnosed in 51 (73.5%) cases, SCC of esophagus in 8 (5.6 %) patients, 1 (0.7%) patient had metastatic lymph node compression of middle part of esophagus and 9 (6.3 %) cases of advanced tumors of HPB system. 3 (2.7 %) cases of EC were complicated by esophageal-bronchial fistula and esophageal-pleural fistula.
Results: To 69 (100%) patients were implanted 77 SEMS. For all patients we used FCSEMS and PCSEMS. The 2 stents “into in” were deployed for 9 (9.3%) patients and 1 stent to 60 (86.8%) patients. For patients with leakage we installed FCSEMS. 10 (7 %) patients with esophageal obstruction had diameter less than 5 mm that appear difficulties to conduct delivery system into stenosis. To these patients before stenting the bougienage was done (33-39 Fr.). The technical success is 100 % and clinical regress of obstruction 95.3 %. Early complications: bleeding in 3 (2.7%) patients and migration in 4 (3.5%) patients. Late complications: migration 5 (7.5%), in growth 3 (2.7%), stent disruption 1 (0.7%), obstruction by food 1 (0.7%). 6 (5.2%) patients noted the heartburn. The stent migration was noted in patients with FCSEMS. All complications were solved by endoscopic (reposition) and drug therapy (PPI). Lethal outcome: 1 (0.7%) patient died caused by profuse bleeding after 1 month of inserting SEMS.
Conclusions: FCSEMS is effective for fistula formation and prevent in growth tissue. PCSEMS prevent migration. In the case of severe stenosis the bougienage before stenting is necessary. However, it requires delicate performance. SEMS shows highly effective for palliation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91901
Program Number: P418
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster