Ces radiol. 2021, 75(2):164-171 | DOI: 10.55095/CesRadiol2021/020

Retrospective analysis of complications associated with metallic esophageal stents implanted under fluoroscopy inside malignant stenosesOriginal article

Peter Matkulčík1, Tomáš Rohan¹, Michal Uher², Jakub Hustý¹, Milan Dastych³, Tomáš Andrašina¹

¹ Klinika radiologie a nukleární medicíny LF MU a FN, Brno

² Institut biostatistiky a analýzy LF MU, Brno

³ Interní gastroenterologická klinika LF MU a FN, Brno

Aim: To identify risk factors, that can possibly allow to predict late complications associated with metallic stents in malignant esophageal stenoses.

Method: Retrospective analysis of patients with implanted metallic stent in malignant esophageal stenoses in years 2005-2019. Frequency and type of complications (dislocation, stent obstruction, fistulae) were observed in dependence on type (Ella, Wallflex, Boubella, Egis) length of stent, implanting operator, age of patient, survival of patient, adjuvant chemotherapy or radiotherapy, malignant stenosis character, extent of prestenotic dilatation. Radiologic parameters were evaluated from contrast swallow before and after stent implantation, remaining information were gathered from the hospital information system. From the statistical methods, the Mann-Whitney test and the t-test were used for the continuous variables, the Chi-squared test for the categorical variables and the Kaplan-Meier and the log-rank test for the survival analysis.

Results: In years 2005-2019, there were 115 metal stents implanted (median 1 per patient). In proximal esophagus, there were 37 stents (32.2%), 78 (67.8%) in distal esophagus. In 25 (21.7%) stents, complications were observed. Median survival rate from stent implantation was 132 days. Significantly higher risk of dislocation was observed in shorter stents (96 ± 16 vs. 116 ± 24 mm; p = 0.008). Other parameters were not significantly associated with the frequency of complications.

Conclusion: Stent length was the only observed statistically significant factor in complications rate of metallic stents implanted in malignant esophageal stenoses, where in shorter stents, the risk of dislocation was significantly higher than in longer stents.

Keywords: self expandable metal stent, esophageal cancer, complications, survival analysis

Grants and funding:

Práce byla napsána v rámci projektu MUNI/A/1342/2020 podpořeného Ministerstvem školství České republiky, dále byla podpořena MZ ČR - RVO (FNBr, 65269705).

Accepted: May 5, 2021; Published: June 1, 2021  Show citation