Observational Study of 30 Cases of Esophageal Stenting with or without Adjuvant Chemoradiotherapy in Patients of Carcinoma Esophagus
Journal Title: New Indian Journal of Surgery - Year 2019, Vol 10, Issue 3
Abstract
Introduction: Esophageal cancer had an estimated 482,300 new cases in 2014 worldwide. The incidence rates of esophageal cancer vary greatly based on region, with the highest rates found in Asia, including China and Central Asia, and in Africa. Presently, a number of endoscopy-based modalities are utilized to palliate these symptoms. Aims & Objectives: To evaluate if esophageal stenting in patients of esophageal carcinoma who has crossed stage of inoperability is of any use in improving symptoms or quality of life. To evaluate whether esophageal stenting is of any role in improving quality of life in inoperable carcinoma esophagus cases To see how esophageal stenting affects perception of pain in patients of esophageal carcinoma. Material and Methods: We conducted an observational study from 2016 to 2018. We included 30 patients with esophageal cancer in whom the cancer had spread beyond the stage of operability and only option available was palliative treatment. Before the start of my study we got approval from ethics committee. Stenting procedure was standardized. We used SEMS (Self Expandable Metallic Stents) for our patients and those were made available free of cost by the hospital administration. SEMS of size 100 mm, 120 mm, 140 mm, or 160 mm were used in different cases depending upon the length of the oesophagus. Observation: In our study we found that all patients had significant relief of dysphagia and improvement in quality of life, though with increase in pain scores. Following stent deployment, the relief of dysphagia is almost immediate lasting and excellent relief of dysphagia has been a consistent finding with the use of SEMS. Complications are uncommon following SEMS placement, major ones being perforation and aspiration pneumonia. In our study perforation was seen in one patient and aspiration pneumonia was observed in two patients. In one study, the procedure had a 7% mortality rate.in our study, there was one procedure-related death. Pain, gastroesophageal reflux and respiratory infection were the commonest complications. Conclusion: We concluded that SEMS placement is safe and effective in the palliation of dysphagia in selected patients with unresectable malignant esophageal carcinoma. It provides lasting relief of dysphagia and improves QOL significantly, without major complications. However SEMS do not increase the life expectancy in these patients. However our study had few limitations and a very small sample size so the results of my study cannot be generalized to the whole population in general.
Authors and Affiliations
Priya Rana
Keywords
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- EP ID EP594656
- DOI 10.21088/nijs.0976.4747.10319.3
- Views 84
- Downloads 0
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