ESOPHAGEAL STENT PLACEMENT FOR DYSPHAGIA PALLIATION IN LUNG CANCER PATIENTS; A TWO YEAR SINGLE CENTER EXPERIENCE

Aims:

Aim of the study was to evaluate the role of self-expandable metal stents (SEMS) for palliation of malignant dysphagia in lung cancer patients.

Methods:

During the period between May 2015 and September 2017 we placed 42 SEMS due to malignant dysphagia in lung cancer patients. Stents have been placed under combined fluoroscopic and endoscopic control over the guide wire (Savary or x-wire) with patients under propofol sedation.

Results:

Data from 42 patient was analysed. 35 pts (83%) were males and the mean age was 68,4 years (range 52 – 80y). In 26 pts (61%) the cause of dyphagia was extraluminal mediastinal lympadenopathy and in others direct tumor infiltration of the esophagus. Tracheoesophageal fistula was seen in 14 pts (33%). Most of the patients (32; 76%) had stage 3 dysphagia (able to swallow liquids only) and the rest (10; 24%) stage 4 (unable to swallow saliva). We have placed total of 42 SEMS (30 – 71% partially covered ant the rest fully covered). Five (12%) stents have been placed over the E-G junction due to infiltration of the cardia. We did not expereince any immediate complications besides aspiration pneumonia in 3 (7%) and minor bleeding in 2 (5%) pts that resolved spontaneously. Dysphagia score improved in all patiens to stage 1 (dysphagia with certain solid food in 16 pts-38%) or stage 2 (able to swallow semi solid in 26 pts-62%). In 3 (7%) pts during the follow-up we encountered tumor overgrowth and in 2 pts the T-E fistula was not sealed so they have been referred for gastrostomy placement. No other long term complications were recorded. Most of the patients (30 – 71%) died during the follow-up, with mean survival of 5 months after the stent placement.

Conclusions:

Placing SEMS in lung cancer patients is safe and highly effective in relieving dysphagia with significant improvement in quality of life.