It has emerged that less than 50% of patients with esophageal carcinoma are suitable for surgery at the time of diagnosis.
Most of these patients present with locally advanced or metastatic disease and/or significant comorbidities. In such circumstances, the only therapeutic option is palliative care to treat dysphagia and prevent respiratory complications secondary to aspiration.
Self-expanding metal stents have been proven effective for palliation of dysphagia in patients with esophageal carcinoma, tracheo-esophageal fistulas or anastomotic leaks.A brief article published on May 14, 2010 in the World Journal of Gastroenterology
reports the experience of an Italian high-volume center for esophageal diseases. Dr. Davide Bona, Professor Luigi Bonavina and his colleagues at University of Milan Medical School, IRCCS Policlinico San Donato, investigated the effectiveness, safety and outcome of two most popular esophageal metal stents in patients with dysphagia. The study confirmed that esophageal stents provided good palliation of dysphagia in patients with inoperable esophageal carcinoma. In these patients, metal stents allowed a better quality of life during chemotherapy administration and were safely removed without compromising the subsequent surgical intervention. Good results were also obtained in the conservative management of anastomotic leaks. The results showed that both types of stents used for the study have similar outcomes and that they can both be used as "bridging" therapy before surgical resection.