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Is Fluoroscopic Guidance Needed for Palliative Esophageal Stenting?

efficacy and safety of endoscopic metal stenting for esophageal malignancy without fluoroscopy. This is a retrospective study of patients with esophageal malignancy who underwent esophageal stenting over a 3-year period. All patients underwent a thorough clinical examination, upper gastrointestinal (GI) endoscopy, and biopsy to confirm the diagnosis. Con-trast-enhanced computed tomography (chest and abdomen) was used to assess the local tumor infiltration and metastasis. The authors excluded patients who were terminally ill with a life expectancy of < 4 weeks. The authors uniformly used partially polyurethane-covered proximal release SEMS in all patients with a diameter of 23/28 mm and length of 3 cm more than the length of the stricture. Prior to placement of SEMS, the controlled radial expansion (CRE) balloon catheter was used to dilate the stricture up to 11 mm to allow the upper GI scope to pass through. In this study, the most common location of the esophageal tumor was in mid esophagus. Following SEMS, the dysphagia severity score among 78 patients was none in 5 (6.4%), mild in 64 (82%), moderate in 9 (11.5%), and severe in 0. The median difference in survival between 78 patients who underwent SEMS was compared with 50 patients who