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9 - Role of Stents in the Management of Esophageal Cancer

Published online by Cambridge University Press:  08 August 2009

By
Tarun Sabharwal  and
Andreas Adam
Edited by
Sheila C. Rankin
Tarun Sabharwal
Affiliation:
Consultant, Interventional Radiologist and Honorary Senior Lecturer, Guy's and St. Thomas' Foundation Trust, Department of Radiology, St. Thomas' Hospital, London, UK
Andreas Adam
Affiliation:
Professor, Interventional Radiology, Guy's, King's and St. Thomas' School of Medicine, London, UK
Sheila C. Rankin
Affiliation:
Guy's and St Thomas' Hospital
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Summary

Introduction

Esophageal cancer is the sixth leading cause of death from malignant disease worldwide. Patients may have no symptoms until the diameter of the esophageal lumen has been reduced by 50%, resulting in late presentation and poor prognosis. Esophageal neoplasms are associated with a poor outcome, with an overall 5-year survival rate of less than 10%. Fewer than 50% of patients are suitable for resection at presentation, and palliation is the best option for those with irresectable lesions.

Esophageal stents for palliation

The aims of palliative treatment are maintenance of oral intake, minimizing hospital stay, relief of pain, elimination of reflux and regurgitation, and prevention of aspiration. Current methods of palliation include thermal ablation, photodynamic therapy, radiotherapy, chemotherapy, chemical injection therapy, argon beam or bipolar electrocoagulation therapy, enteral feeding (nasogastric tube/percutaneous endoscopic gastrostomy), and intubation with self-expanding metal stents (SEMS) or semirigid prosthetic tubes.

Endoluminal esophageal prostheses have been in use for over a century. A variety of tubes inserted using pulsion or traction have been described. Leroy d'Etiolles made the earliest device in 1845 of decalcified ivory, followed by Charters J. Symonds who introduced the first metal esophageal prosthesis in 1885. Esophageal stenting using SEMS is the commonest modern means of palliation and is associated with high success rates and relatively few complications.

Type
Chapter
Information
Carcinoma of the Esophagus , pp. 134 - 144
Publisher: Cambridge University Press
Print publication year: 2007

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  • Role of Stents in the Management of Esophageal Cancer
    • By Tarun Sabharwal, Consultant, Interventional Radiologist and Honorary Senior Lecturer, Guy's and St. Thomas' Foundation Trust, Department of Radiology, St. Thomas' Hospital, London, UK, Andreas Adam, Professor, Interventional Radiology, Guy's, King's and St. Thomas' School of Medicine, London, UK
  • Edited by Sheila C. Rankin
  • Book: Carcinoma of the Esophagus
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545443.011
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  • Role of Stents in the Management of Esophageal Cancer
    • By Tarun Sabharwal, Consultant, Interventional Radiologist and Honorary Senior Lecturer, Guy's and St. Thomas' Foundation Trust, Department of Radiology, St. Thomas' Hospital, London, UK, Andreas Adam, Professor, Interventional Radiology, Guy's, King's and St. Thomas' School of Medicine, London, UK
  • Edited by Sheila C. Rankin
  • Book: Carcinoma of the Esophagus
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545443.011
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Role of Stents in the Management of Esophageal Cancer
    • By Tarun Sabharwal, Consultant, Interventional Radiologist and Honorary Senior Lecturer, Guy's and St. Thomas' Foundation Trust, Department of Radiology, St. Thomas' Hospital, London, UK, Andreas Adam, Professor, Interventional Radiology, Guy's, King's and St. Thomas' School of Medicine, London, UK
  • Edited by Sheila C. Rankin
  • Book: Carcinoma of the Esophagus
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545443.011
Available formats
×