Diagnostic Yields Of Endoscopic Ultrasound
Knyrim reported the outcomes of a randomized trial evaluating an expandable metallic stent with rigid plastic prostheses in 42 sufferers. Dysphagia improved equally in each therapy groups, but issues were considerably less frequent in patients who obtained expandable stents.
The steel stent group had a decrease 1-month mortality than the expandable stent group (14% vs 29%) and a significantly shorter hospital stay . When rigid stents are used, migration of the prosthesis or tube dislocation happens in more than 10% of sufferers.
Obstruction could also be caused by a food impaction, tumor development, or reflux-induced strictures. Pressure necrosis leading to fistula and hemorrhage due to erosion have been reported.
The indications for stent placement include the aid of dysphagia in sufferers with unresectable esophageal carcinoma and the treatment of trans- esophageal fistulas. A stent is the treatment of choice for fistulas resulting from either the pure historical past of the malignancy or for iatrogenic fistulas.
One type of inflexible prosthesis for fistulas incorporates a collapsed sponge in a polymeric balloon that encircles the stent. Once the stent is in place, a vacuum is released in the masking balloon and the sponge expands to occlude the fistula lumen . Some expandable steel prostheses have a polymeric sheet that covers the metallic mesh and are supposed to treat fistulas and decrease tumor ingrowth. The absolute and relative contraindications to rigid stent placement and contraindications that are overcome by the expandable metal stents are noted in Table four.