Ferdane SAPMAZ, Sebahat BAŞYİĞİT, METİN UZMAN, Yaşar NAZLIGÜL

Malign özofageal disfajisi olan vakalarda içten kaplı kendiliğinden genişleyebilen metal stent uygulamalarımızın etkinlik ve güvenliğinin değerlendirilmesi

Giriş ve Amaç: Kendiliğinden genişleyebilen metalik stentler malign disfajide palyatif bir tedavi yöntemidir. Çalışmamızın amacı malign özofagus darlıklarında içten kaplı kendiliğinden genişleyebilen metalik stent uygulamalarımızın etkinlik ve güvenliğini değerlendirmektir. Gereç ve Yöntem: Ocak 2014-Temmuz 2015 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi Gastroenteroloji Kliniğinde malign disfaji nedeni ile içten kaplı kendiliğinden genişleyebilen metalik stent uygulanmış 22 hasta çalışmaya dahil edildi. Hastalar, yaş, cinsiyet, primer malig- nensi odağı, darlık uzunluğu, darlık lokasyonu, trakeözofageal fistül varlığı açısından değerlendirildiler. Hastalar işlem ilişkili komplikasyonlar açısından takip edildiler. Ortalama takip süresi 28 hafta idi (4 ila 48 hafta). Bulgular: 19 hasta (86%) erkek ve 3 (14%) hasta kadındı. En genç hasta 31, en yaşlı hasta 72 yaşında idi (ortalama yaş: 58,1±10,4 yıl). Ortalama disfaji skorları stent uygulamasından önce 3.0±0.61 iken, kendiliğinden genişleyebilen metalik stent sonrası 1,1±0,75e geriledi. Hastalarımızda işlem ilişkili ciddi komplikasyon yaşanmadı. Sonuç: Kliniğimizde malign disfajilerde beslenmenin devamının sağlanması ve disfaji palyasyonu açısından tercih edilen içten kaplı kendiliğinden genişleyebilen metalik stentler son derecede etkili ve güvenli bir şekilde uygulanmaktadır.

Evaluation of efficacy and safety of our experiences with internally covered self-expandable metal stent in cases with malignant esophageal dysphagia

Background and Aims: Self-expandable metal stents are an established palliative therapy for malignant dysphagia. The aim of our study was to evaluate the efficacy and safety of our experiences with internally covered self-expandable metal stents in cases with malignant esophageal strictures. Materials and Methods: 22 patients with advanced malignant dysphagia, who underwent esophageal internally covered self-expandable metal stent implementation at Keçioren Research and Training Hospital, Department of Gastroenterology between January 2015 and July 2015, were included in this study. The patients were evaluated for age, gender, primary malignancy focus, stricture location and length, and presence of tracheoesophageal fistula. Follow up for procedure related complications and dysphagia scores was performed, with a mean follow-up time of 28 weeks (range, 4 to 48). Results: 19 patients, (86%) were male and 3 (14%) female, were included in the study. The youngest patient was 31 years of age, while the oldest was 72 years of age (mean age, 58,1±10,4 years). Mean dysphagia scores (scale 0-4) improved from 3.0±0.61 to 1.1±0.75 after self-expandable metal stent implantation. There were no procedure-related major complications in this series. Conclusion: In our clinic, internally covered self-expandable metal stents, which are preferred for maintaining the nutrition and palliation of dysphagia in cases with malignant dysphagia, are used safely and effectively.

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