Self-expanding metal mesh stents and laser therapy: a complementary approach for the palliation of malignant dysphagia

Ravi Madhotra; A. Raouf; R. Sturgess; Neville Krasner M.D.

doi:10.1117/12.297853

22 December 1997 Self-expanding metal mesh stents and laser therapy: a complementary approach for the palliation of malignant dysphagia

Ravi Madhotra, A. Raouf, R. Sturgess, Neville Krasner M.D.

Author Affiliations +

Proceedings Volume 3192, Medical Applications of Lasers in Dermatology, Ophthalmology, Dentistry, and Endoscopy; (1997) https://doi.org/10.1117/12.297853
Event: BiOS Europe '97, 1997, San Remo, Italy

Abstract

Re-establishment of the oesophageal lumen is the main focus of care in patients with inoperable oesophageal carcinomas. The self-expanding metal mesh stents (MMS) are increasingly being used. 51 patients aged 44 - 89 with inoperable oesophago-gastric carcinomas were intubated with MMS. 18 of these patients had endoscopic laser therapy (ELT) as primary palliation. 25 patients required follow-up endoscopy at variable intervals after stent insertion. 17 patients were found to have significant tumor growth (9), overgrowth (4) and both (4). All these patients were treated with Nd:YAG or diode laser for maintenance of satisfactory swallowing. 4 patients being treated with Nd:YAG laser developed deformity of MMS. This complication was not encountered with diode laser. The reblockage of MMS due to ingrowth or overgrowth of tumor is a not uncommon complication. The timing of the stent insertion should be carefully chosen since the longer the stent is in situ, the greater is the likelihood of tumor ingrowth or overgrowth. ELT can effectively deal with tumor ingrowth and overgrowth. Nd:YAG laser can cause melting of MMS. Overall the combination of ELT and MMS may offer the best palliation, particularly when patient survival of several months is anticipated.

Citation Download Citation

Ravi Madhotra, A. Raouf, R. Sturgess, and Neville Krasner M.D. "Self-expanding metal mesh stents and laser therapy: a complementary approach for the palliation of malignant dysphagia", Proc. SPIE 3192, Medical Applications of Lasers in Dermatology, Ophthalmology, Dentistry, and Endoscopy, (22 December 1997); https://doi.org/10.1117/12.297853

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KEYWORDS

Laser therapeutics

Metals

Tumors

Nd:YAG lasers

Endoscopy

Semiconductor lasers

Laser development

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