Self - Expanding UltraflexTM Esophageal Prosthesis of Malignant Esophageal Stenosis

Lee, Joon Seong; Park, Chan Wook; Choi, Jae Dong; Lee, Moon Sung; Kim, Jin Hong; Cho, Sung Won; Shim, Chan Sup

Abstract

Endoscopic intubation is well established as a cheap, fast and durable procedure for palliation of malignant dysphagia. However, the placement of conventional esophageal endopros-thesis is difficult in some cases and this procedure is associated with significant complications such as perforation, hemorrhage and dysfunetion of the prosthesis in the long term. The self-expanding metallic stents offer an attractive alternative to conventional esophageal stents. These can be compressed into and inserted through a small lumen catheter, making placement easier, safer and less painful to patients. But, open mesh of self-expanding metallic stent such as Wallstent allows tumor ingrowth, unfinished wire ends can lead to perforation and bleeding, and immense stent shortening makes precise positioning difficult. Inflammatory response at site of the metal strut, difficulty in retrieving prostheses that place and very expensiveness in cost-benefit analysis are also problems. Recently developed Ultraflex" esophageal prosthesis is knitted from single strand of Elastalloy' wire, undulates to conform with normal esophageal peristalsis, maintaining patency and promoting patient comfort. Unlike other metallic stent that have sharp, bare-wire ends, the Ultraflex' Stent has smooth looped ends, with Teco-flex coating, which provide an atraumatic transition from the stent to the esophageal wall. We experienced a case of a 60-year old male with malignant stenosis of esophageal cancer in whom Ultraflex esophageal prosthesis was implanted with successful oral nutrition.