Endoscopic Palliation of Malignant Dysphagia

To the Editor: In the Images in Clinical Medicine series (Aug. 15 issue), 1 Wong and Van Dam described a case in which an expandable metallic esophageal prosthesis spared their patient considerable discomfort and expense. Expandable metal stents, especially the latest “coated” ones that retard the ingrowth of tumors, are an important advance in the treatment of inoperable esophageal cancer. However, the placement of these stents is not without risk. My colleagues and I have encountered a high complication rate in our initial experience in 11 patients with the five types of expandable metallic stents currently available. Two patients had intractable . . .