Gut Liver.  2017 Jan;11(1):47-54. 10.5009/gnl16172.

Factors That Affect Stent-Related Complications in Patients with Malignant Obstruction of the Esophagus or Gastric Cardia

• Iwasaki H
• Mizushima
• Suzuki Y
• Fukusada S
• Kachi K
• Ozeki T
• Anbe K
• Tsukamoto
• Okumura F
• Joh T
• Sano H

• KMID: 2412154
• DOI: http://doi.org/10.5009/gnl16172

Abstract

BACKGROUND/AIMS
Self-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting.
METHODS
Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified. The occurrence of stent-related complications was used as an endpoint.
RESULTS
Stent-related complications were identified in 26 patients (49.1%), and major complications occurred in 14 patients (26.4%). The use of an Ultraflex stent (odds ratio [OR], 6.81; 95% confidence interval [CI], 1.54 to 30.00; p=0.011) and prior chemotherapy (OR, 6.13; 95% CI, 1.46 to 25.70; p=0.013) were significantly associated with stent-related complications. Moreover, the use of an Ultraflex stent (OR, 19.60; 95% CI, 2.26 to 170.00; p=0.007) and prior radiation (OR, 25.70; 95% CI, 2.37 to 280.00; p=0.008) significantly increased the risk of major complications.
CONCLUSIONS
The use of an Ultraflex stent and prior radiation and/or chemotherapy may represent risk factors for complications following esophageal SEMS placement.

Keyword

Esophageal stent; Risk factors; Complication; Radiation; Chemotherapy

MeSH Terms

Adenocarcinoma/complications/*surgery
Aged
Aged, 80 and over
Antineoplastic Agents/therapeutic use
Carcinoma, Squamous Cell/complications/*surgery
Cardia/*surgery
Chemoradiotherapy
Constriction, Pathologic
Deglutition Disorders/etiology/*surgery
Esophageal Fistula/epidemiology
Esophageal Neoplasms/complications/*surgery
Esophageal Perforation/epidemiology
Esophageal Stenosis/etiology/*surgery
Esophagoscopy
Female
Fever/epidemiology
Gastroscopy
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Palliative Care
Pneumonia, Aspiration/epidemiology
Postoperative Complications/*epidemiology
Postoperative Hemorrhage/epidemiology
Prosthesis Failure
Radiotherapy
Retrospective Studies
*Self Expandable Metallic Stents
Stomach Diseases/etiology/*surgery
Antineoplastic Agents