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A comparison of laser therapy, plastic stents, and expandable metal stents for palliation of malignant dysphagia in patients without a fistula.

Abstract：

BACKGROUND:Many options are available for palliation of inoperable malignant stenoses of the esophagus. We report our experience with different modalities of endoscopic therapy. METHODS:From 1986 to 1996, we treated 125 patients with dysphagia caused by unresectable malignant tumors with endoscopic therapy. Seventy patients were treated with laser therapy, 34 with a plastic endoprosthesis, and 21 with an expandable prosthesis. Therapeutic outcome and complication rates were analyzed for the three groups. RESULTS:Mean dysphagia score decreased in the same manner in all three groups. Major and minor complications were significantly more common in the plastic endoprosthesis group and in the metallic stent group compared with the laser therapy group. Therapy and patient survival were not significantly different among the three groups. CONCLUSIONS:Plastic and metal stents carry a high complication rate for a short period of palliation. Endoscopic laser therapy, in contrast, has a low complication rate. Laser therapy should be the first choice for palliation in malignant dysphagia in patients with a short life expectancy. Stents might be used when laser therapy fails, in the presence of fistulas, or in patients with a reasonable life expectancy.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Gevers AM,Macken E,Hiele M,Rutgeerts P

doi

10.1016/s0016-5107(98)70007-0

subject

Has Abstract

pub_date

1998-10-01 00:00:00

pages

383-8

issue

4

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(98)70007-0

journal_volume

48

pub_type

杂志文章

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