A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma
Background: Covered metallic oesophageal stents offer effective palliation of malignant oesophageal strictures. However, first generation devices were associated with a high rate of migration, particularly when used in the lower oesophagus. Aim: To compare the rate of complications and palliative ef...
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| Veröffentlicht in: | Gut 2003-07, Vol.52 (7), p.922-926 |
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| creator | Sabharwal, T Hamady, M S Chui, S Atkinson, S Mason, R Adam, A |
| description | Background: Covered metallic oesophageal stents offer effective palliation of malignant oesophageal strictures. However, first generation devices were associated with a high rate of migration, particularly when used in the lower oesophagus. Aim: To compare the rate of complications and palliative effect of two newer covered metallic oesophageal stents. Patients and methods: We performed a prospective randomised study using two of these newer stent designs in the treatment of malignant lower third oesophageal tumours. Fifty three patients with dysphagia due to inoperable oesophageal carcinoma involving the lower third of the oesophagus were randomly selected to receive either a Flamingo covered Wallstent (Boston Scientific Inc., Watertown, Massachusetts, USA) or an Ultraflex covered stent (Boston Scientific Inc.). Dysphagia was scored on a five point scale, recorded before stent insertion, the day after, and at least one month later at follow up. Technical success, early and late complications (perforation, migration, severe gastro-oesophageal reflux, haematemesis, and reobstruction due to tumour overgrowth) were also recorded. Results: In both stent groups, a significant improvement in dysphagia score was seen both the next day post stenting and at late follow up (p0.1). The frequency of complications encountered in the two groups was similar. Three patients in the Ultraflex group required two stents at primary stenting. Conclusion: The two types of stent are equally effective in the palliation of dysphagia associated with lower third oesophageal malignancy and the complication rates associated with their use are comparable. |
| doi_str_mv | 10.1136/gut.52.7.922 |
| format | Article |
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However, first generation devices were associated with a high rate of migration, particularly when used in the lower oesophagus. Aim: To compare the rate of complications and palliative effect of two newer covered metallic oesophageal stents. Patients and methods: We performed a prospective randomised study using two of these newer stent designs in the treatment of malignant lower third oesophageal tumours. Fifty three patients with dysphagia due to inoperable oesophageal carcinoma involving the lower third of the oesophagus were randomly selected to receive either a Flamingo covered Wallstent (Boston Scientific Inc., Watertown, Massachusetts, USA) or an Ultraflex covered stent (Boston Scientific Inc.). Dysphagia was scored on a five point scale, recorded before stent insertion, the day after, and at least one month later at follow up. Technical success, early and late complications (perforation, migration, severe gastro-oesophageal reflux, haematemesis, and reobstruction due to tumour overgrowth) were also recorded. Results: In both stent groups, a significant improvement in dysphagia score was seen both the next day post stenting and at late follow up (p<0.05). No significant difference was seen in the improvement in dysphagia between the two groups (p>0.1). The frequency of complications encountered in the two groups was similar. Three patients in the Ultraflex group required two stents at primary stenting. Conclusion: The two types of stent are equally effective in the palliation of dysphagia associated with lower third oesophageal malignancy and the complication rates associated with their use are comparable.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>EISSN: 1458-3288</identifier><identifier>DOI: 10.1136/gut.52.7.922</identifier><identifier>PMID: 12801944</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Care and treatment ; Deglutition disorders ; Deglutition Disorders - etiology ; Deglutition Disorders - therapy ; Diseases of the digestive system ; Dysphagia ; Endoscopy ; Equipment Design ; Esophageal cancer ; Esophageal Neoplasms - complications ; Esophageal Neoplasms - surgery ; Evaluation ; Female ; Humans ; Male ; Medical sciences ; metallic stents ; Middle Aged ; oesophageal carcinoma ; Oesophagus ; Pain ; palliation ; Palliative Care - methods ; Patient outcomes ; Patients ; Prospective Studies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; self expanding metallic stents ; SEMS ; Stent (Surgery) ; Stents ; Treatment Outcome ; Tumors</subject><ispartof>Gut, 2003-07, Vol.52 (7), p.922-926</ispartof><rights>Copyright 2003 by Gut</rights><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2003 Copyright 2003 by Gut</rights><rights>Copyright © Copyright 2003 by Gut 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b614t-435abcc292cf401de5c5386865ffa15d532b7cd232b34efd873329a67c7f89593</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773700/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773700/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14868893$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12801944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sabharwal, T</creatorcontrib><creatorcontrib>Hamady, M S</creatorcontrib><creatorcontrib>Chui, S</creatorcontrib><creatorcontrib>Atkinson, S</creatorcontrib><creatorcontrib>Mason, R</creatorcontrib><creatorcontrib>Adam, A</creatorcontrib><title>A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma</title><title>Gut</title><addtitle>Gut</addtitle><description>Background: Covered metallic oesophageal stents offer effective palliation of malignant oesophageal strictures. However, first generation devices were associated with a high rate of migration, particularly when used in the lower oesophagus. Aim: To compare the rate of complications and palliative effect of two newer covered metallic oesophageal stents. Patients and methods: We performed a prospective randomised study using two of these newer stent designs in the treatment of malignant lower third oesophageal tumours. Fifty three patients with dysphagia due to inoperable oesophageal carcinoma involving the lower third of the oesophagus were randomly selected to receive either a Flamingo covered Wallstent (Boston Scientific Inc., Watertown, Massachusetts, USA) or an Ultraflex covered stent (Boston Scientific Inc.). Dysphagia was scored on a five point scale, recorded before stent insertion, the day after, and at least one month later at follow up. Technical success, early and late complications (perforation, migration, severe gastro-oesophageal reflux, haematemesis, and reobstruction due to tumour overgrowth) were also recorded. Results: In both stent groups, a significant improvement in dysphagia score was seen both the next day post stenting and at late follow up (p<0.05). No significant difference was seen in the improvement in dysphagia between the two groups (p>0.1). The frequency of complications encountered in the two groups was similar. Three patients in the Ultraflex group required two stents at primary stenting. Conclusion: The two types of stent are equally effective in the palliation of dysphagia associated with lower third oesophageal malignancy and the complication rates associated with their use are comparable.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Care and treatment</subject><subject>Deglutition disorders</subject><subject>Deglutition Disorders - etiology</subject><subject>Deglutition Disorders - therapy</subject><subject>Diseases of the digestive system</subject><subject>Dysphagia</subject><subject>Endoscopy</subject><subject>Equipment Design</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - complications</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>metallic stents</subject><subject>Middle Aged</subject><subject>oesophageal carcinoma</subject><subject>Oesophagus</subject><subject>Pain</subject><subject>palliation</subject><subject>Palliative Care - methods</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>self expanding metallic stents</subject><subject>SEMS</subject><subject>Stent (Surgery)</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0017-5749</issn><issn>1468-3288</issn><issn>1458-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kstu1DAUhiMEoqWwY40sIWBDBt8SJxuk0YgySC1sKF1aHsfOeHDi1M708jS8KmeUUQdQhbyw5POd_1z8Z9lLgmeEsPJDux1nBZ2JWU3po-yY8LLKGa2qx9kxxkTkheD1UfYspQ3GuKpq8jQ7IrTCpOb8OPs1R1H1TehcMg0aYkiD0aO7NkiHblDRpdCjYNG4NujUq871bUCXyvs0mn5EkIou_BiV9eYWTW82RDQA4dTopuTmLg1r1TqFVEpBQwBq3bhxjXy4MRHEXWxQMCnsMKM80ipq14dOPc-eWOWTebG_T7KL00_fF8v87NvnL4v5Wb4qCR9zzgq10prWVFuOSWMKXbCqrMrCWkWKpmB0JXRD4WLc2KYSjNFalUILW9VFzU6yj5PusF11ptEwSFReDtF1Kt7JoJz8O9K7tWzDtSRCMIExCLzdC8RwtTVplLBSbbxXvQnbJKFgiXkpAHz9D7gJ29jDcDutmlFCaw5UPlGt8ka63gaoqlvTGygeemMdPM8J5oJxzAvgZw_wcBrTOf1gwvspQcOfp2js_awEy52xJBhLFlQKCcYC_NWf-znAeycB8GYPqKSVt-Aq7dKB4_AbVc0Ogzlwy-19XMWfEpYjCvn1x0JeLs8rsSzP5a7PdxO_6jb_b_E3BLn1yw</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>Sabharwal, T</creator><creator>Hamady, M S</creator><creator>Chui, S</creator><creator>Atkinson, S</creator><creator>Mason, R</creator><creator>Adam, A</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>Copyright 2003 by Gut</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20030701</creationdate><title>A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma</title><author>Sabharwal, T ; Hamady, M S ; Chui, S ; Atkinson, S ; Mason, R ; Adam, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b614t-435abcc292cf401de5c5386865ffa15d532b7cd232b34efd873329a67c7f89593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Deglutition disorders</topic><topic>Deglutition Disorders - etiology</topic><topic>Deglutition Disorders - therapy</topic><topic>Diseases of the digestive system</topic><topic>Dysphagia</topic><topic>Endoscopy</topic><topic>Equipment Design</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - complications</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Evaluation</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>metallic stents</topic><topic>Middle Aged</topic><topic>oesophageal carcinoma</topic><topic>Oesophagus</topic><topic>Pain</topic><topic>palliation</topic><topic>Palliative Care - methods</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>self expanding metallic stents</topic><topic>SEMS</topic><topic>Stent (Surgery)</topic><topic>Stents</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sabharwal, T</creatorcontrib><creatorcontrib>Hamady, M S</creatorcontrib><creatorcontrib>Chui, S</creatorcontrib><creatorcontrib>Atkinson, S</creatorcontrib><creatorcontrib>Mason, R</creatorcontrib><creatorcontrib>Adam, A</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Science Journals</collection><collection>ProQuest Biological Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sabharwal, T</au><au>Hamady, M S</au><au>Chui, S</au><au>Atkinson, S</au><au>Mason, R</au><au>Adam, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>52</volume><issue>7</issue><spage>922</spage><epage>926</epage><pages>922-926</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><eissn>1458-3288</eissn><coden>GUTTAK</coden><abstract>Background: Covered metallic oesophageal stents offer effective palliation of malignant oesophageal strictures. However, first generation devices were associated with a high rate of migration, particularly when used in the lower oesophagus. Aim: To compare the rate of complications and palliative effect of two newer covered metallic oesophageal stents. Patients and methods: We performed a prospective randomised study using two of these newer stent designs in the treatment of malignant lower third oesophageal tumours. Fifty three patients with dysphagia due to inoperable oesophageal carcinoma involving the lower third of the oesophagus were randomly selected to receive either a Flamingo covered Wallstent (Boston Scientific Inc., Watertown, Massachusetts, USA) or an Ultraflex covered stent (Boston Scientific Inc.). Dysphagia was scored on a five point scale, recorded before stent insertion, the day after, and at least one month later at follow up. Technical success, early and late complications (perforation, migration, severe gastro-oesophageal reflux, haematemesis, and reobstruction due to tumour overgrowth) were also recorded. Results: In both stent groups, a significant improvement in dysphagia score was seen both the next day post stenting and at late follow up (p<0.05). No significant difference was seen in the improvement in dysphagia between the two groups (p>0.1). The frequency of complications encountered in the two groups was similar. Three patients in the Ultraflex group required two stents at primary stenting. Conclusion: The two types of stent are equally effective in the palliation of dysphagia associated with lower third oesophageal malignancy and the complication rates associated with their use are comparable.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>12801944</pmid><doi>10.1136/gut.52.7.922</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Care and treatment Deglutition disorders Deglutition Disorders - etiology Deglutition Disorders - therapy Diseases of the digestive system Dysphagia Endoscopy Equipment Design Esophageal cancer Esophageal Neoplasms - complications Esophageal Neoplasms - surgery Evaluation Female Humans Male Medical sciences metallic stents Middle Aged oesophageal carcinoma Oesophagus Pain palliation Palliative Care - methods Patient outcomes Patients Prospective Studies Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) self expanding metallic stents SEMS Stent (Surgery) Stents Treatment Outcome Tumors |
| title | A randomised prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma |
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