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Article: The use of self-expanding metallic stents (SEMS) is effective in symptom palliation from recurrent tumor after esophagogastrectomy for cancer

TitleThe use of self-expanding metallic stents (SEMS) is effective in symptom palliation from recurrent tumor after esophagogastrectomy for cancer
Authors
Issue Date2010
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/DES
Citation
Diseases Of The Esophagus, 2010, v. 23 n. 8, p. 660-665 How to Cite?
AbstractThe efficacy of using self-expanding metallic stent (SEMS) for palliation of symptoms because of tumor recurrence after prior esophagogastrectomy has not been properly assessed despite the well recognized use of SEMS in patients without prior surgery. The aim of this study is to evaluate the efficacy and safety of using SEMS in patients who had prior esophagogastrectomy. The study group included 35 patients with carcinoma of esophagus or cardia documented to have loco-regional recurrence after esophagogastrectomy and in whom SEMS were placed for palliation. The median age was 67 (ranged 41-85). The indications for stenting were dysphagia caused by recurrence at the esophageal anastomosis (n= 4) and in the esophageal remnant (n= 5), or extrinsic compression from mediastinal nodal disease (n= 7); gastric outlet obstruction produced by extrinsic tumor compression (n= 13); and tracheo-esophageal fistulae (n=6). Forty-three stenting procedures were performed, and the technical success rate was 97.6%. The dysphagia score improved from 4.66 to 2.54 (P < 0.001). All patients with tracheo-esophageal fistula had their symptoms successfully palliated. The immediate complication rate was 14% (n= 5); two patients had stent malpositioning, two had inadequate opening of their stents, and one had a failed stenting procedure. On follow-up, 15 (42.8%) patients required a total of 22 re-intervention procedures for various reasons: endoscopic dilatation (five dilatations in three patients), removal of foreign bodies (nine procedures in four patients), and insertion of a second SEMS related to tumor growth (eight stents in eight patients). There was no procedure-related mortality. The median survival was short at 42 days (range 5-290 days), mostly related to advanced disease stage. SEMS in patients with recurrent tumor after esophagogastrectomy is safe and effective. © 2010 Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.
Persistent Identifierhttp://hdl.handle.net/10722/173012
ISSN
2015 Impact Factor: 2.146
2015 SCImago Journal Rankings: 0.760
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTong, DKHen_US
dc.contributor.authorLaw, Sen_US
dc.contributor.authorWong, KHen_US
dc.date.accessioned2012-10-30T06:26:28Z-
dc.date.available2012-10-30T06:26:28Z-
dc.date.issued2010en_US
dc.identifier.citationDiseases Of The Esophagus, 2010, v. 23 n. 8, p. 660-665en_US
dc.identifier.issn1120-8694en_US
dc.identifier.urihttp://hdl.handle.net/10722/173012-
dc.description.abstractThe efficacy of using self-expanding metallic stent (SEMS) for palliation of symptoms because of tumor recurrence after prior esophagogastrectomy has not been properly assessed despite the well recognized use of SEMS in patients without prior surgery. The aim of this study is to evaluate the efficacy and safety of using SEMS in patients who had prior esophagogastrectomy. The study group included 35 patients with carcinoma of esophagus or cardia documented to have loco-regional recurrence after esophagogastrectomy and in whom SEMS were placed for palliation. The median age was 67 (ranged 41-85). The indications for stenting were dysphagia caused by recurrence at the esophageal anastomosis (n= 4) and in the esophageal remnant (n= 5), or extrinsic compression from mediastinal nodal disease (n= 7); gastric outlet obstruction produced by extrinsic tumor compression (n= 13); and tracheo-esophageal fistulae (n=6). Forty-three stenting procedures were performed, and the technical success rate was 97.6%. The dysphagia score improved from 4.66 to 2.54 (P < 0.001). All patients with tracheo-esophageal fistula had their symptoms successfully palliated. The immediate complication rate was 14% (n= 5); two patients had stent malpositioning, two had inadequate opening of their stents, and one had a failed stenting procedure. On follow-up, 15 (42.8%) patients required a total of 22 re-intervention procedures for various reasons: endoscopic dilatation (five dilatations in three patients), removal of foreign bodies (nine procedures in four patients), and insertion of a second SEMS related to tumor growth (eight stents in eight patients). There was no procedure-related mortality. The median survival was short at 42 days (range 5-290 days), mostly related to advanced disease stage. SEMS in patients with recurrent tumor after esophagogastrectomy is safe and effective. © 2010 Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/DESen_US
dc.relation.ispartofDiseases of the Esophagusen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCarcinoma - Pathology - Surgeryen_US
dc.subject.meshDeglutition Disorders - Etiology - Therapyen_US
dc.subject.meshEsophageal Neoplasms - Pathology - Surgeryen_US
dc.subject.meshEsophagectomyen_US
dc.subject.meshEsophagogastric Junction - Pathology - Physiopathologyen_US
dc.subject.meshEvaluation Studies As Topicen_US
dc.subject.meshFemaleen_US
dc.subject.meshGastrectomyen_US
dc.subject.meshGastric Outlet Obstruction - Etiology - Therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeoplasm Recurrence, Local - Complications - Mortality - Physiopathologyen_US
dc.subject.meshPalliative Careen_US
dc.subject.meshStents - Adverse Effectsen_US
dc.subject.meshStomach Neoplasms - Pathology - Surgeryen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleThe use of self-expanding metallic stents (SEMS) is effective in symptom palliation from recurrent tumor after esophagogastrectomy for canceren_US
dc.typeArticleen_US
dc.identifier.emailLaw, S: slaw@hku.hken_US
dc.identifier.authorityLaw, S=rp00437en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1442-2050.2010.01077.xen_US
dc.identifier.pmid20545971-
dc.identifier.scopuseid_2-s2.0-78649516530en_US
dc.identifier.hkuros183812-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78649516530&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume23en_US
dc.identifier.issue8en_US
dc.identifier.spage660en_US
dc.identifier.epage665en_US
dc.identifier.isiWOS:000284368100010-
dc.publisher.placeAustraliaen_US
dc.identifier.scopusauthoridTong, DKH=8670837000en_US
dc.identifier.scopusauthoridLaw, S=7202241293en_US
dc.identifier.scopusauthoridWong, KH=36485841700en_US
dc.identifier.citeulike8334394-

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