Mahmut SUBAŞI, Bekir KAPLAN, Zeynep TÜRKTARHAN PAÇİN, Erdal YEKELER, Bayram ALTUNTAŞ

Palliation of malignant dysphagia with self expandable esophageal stents

Amaç: Bu makalede malign disfajili hastalardan oluşanardışık bir seride, kendiliğinden genişleyebilen metalik veplastik stentlerle ilgili deneyimlerimiz sunuldu.Çalışmaplanı: Mayıs 2009 - Ağustos 2012 tarihleriarasında Erzurum Bölge Eğitim ve Araştırma HastanesiGöğüs Cerrahisi Kliniğinde malign özofageal darlığı olanve özofageal stent takılan 43 hasta (29 erkek, 14 kadın;ort. yaş 65.4 yıl; dağılım 39-87 yıl) çalışmaya alındı. Ortave alt özofagusta darlığı olan 38 hastaya kendiliğindengenişleyebilen metalik stent (SEMS), fistülü olan veyadarlığı üst özofagusta olan beş hastaya kendiliğindengenişleyebilen plastik stent (SEPS) takıldı. Ortalama takipsüresi dokuz aydı (1-39 ay). Dört hasta sağ ve halen takipedilmektedir.Bul gu lar: Kırk üç hastaya toplam 54 adet stent yerleştirildi.Otuz sekiz hastada 49 adet kaplı SEMS ve beş hastada beşadet kaplı SEPS uygulandı. Orta ve alt özofageal darlığıolan sekiz hastada iki kaplı SEMS ve özofageal darlığıolan bir hastada dört kaplı SEMS gereksinimi oldu. Birhasta kardiyak aritmi nedeniyle ameliyatın ikinci günündekaybedildi. Bir diğer hastada SEMS implantasyonusonrasında trakeoözofageal fistül gelişti. Tüm hastalarınoral gıda alımı düzeldi.Sonuç: Kendiliğinden genişleyebilen özofageal stentler,malign disfajili hastalarda etkili bir palyasyon yöntemidir.

Malign disfajinin kendiliğinden genişleyebilen özofageal stentlerle palyasyonu

Background: In this article, we report our experience witha self-expandable metalic and plastic stent in a consecutiveseries of patients with malignant dysphagia. Methods: Between May 2009 and August 2012, 43 patients (29males, 14 females; mean age 65.4 years; range 39 to 87 years) withmalignant esophageal stenoses, who underwent esophageal stentimplementation in Thoracic Surgery Department of ErzurumRegional Training and Research Hospital were included in thisstudy. The self expandable metalic stents (SEMS) was chosenin 38 patients with stenotic lesion which located middle andlower esophagus, and the self expandable plastic stents (SEPS)was chosen in five patient with fistula or upper esophageallocalization. The mean follow-up was nine months (1 to 39months). Four patients are live and has been under follow-up. Results: A total of 54 stents were placed in 43 patients. Forty- nine covered SEMSs were placed in 38 patients and five coveredSEPSs were placed in five patients. Eight of the patients withmiddle and lower esophageal stenosis needed two coveredSEMS and one with middle esophageal stenosis needed fourcovered SEMS. One patient died because of cardiac arrhythmiaon the postoperative second day. A tracheoesophageal fistuladeveloped four months after the SEMS implantation in another.All patients improved in oral food intake. Conclusion: Self expandable esophageal stents are effectivepalliation methods in patients with malignant dysphagia.

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