Authors' objectives:

This report aims to assess the effectiveness of self-expanding metallic stents in the palliation of dysphagia in patients with malignant esophageal strictures.

Authors' recommendations: Esophageal self-expanding metallic stents (SEMS) are used primarily for the palliation of malignant dysphagia and esophagorespiratory fistulas. Our literature review showed that SEMS immediately relieved dysphagia in approximately 89% of the patients, and the palliation was maintained for a mean of approximately 60 days (mean survival 137 days). Although complications may occur with these devices, the evidence shows a clinically meaningful reduction in the mean dysphagia score corresponding to an improved ability to eat and resulting in an overall benefit in quality of life. Despite the variation in the results seen in the published studies, we estimate that the use of SEMS in patients with malignant dysphagia and esophagorespiratory fistulas is relatively safe, improves patients quality of life, and has a limited budgetary impact to the MUHC. Based on the above considerations, TAU recommends the use of esophageal self-expanding metallic stents (SEMS) in patients with malignant dysphagia and esophagorespiratory fistulas.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.mcgill.ca/tau/publications/2003

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Technology Assessment Unit of the McGill University Health Centre (MUHC)

Contact Address: Technology Assessment Unit of the MUHC, Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, 5252 boul. de Maisonneuve, Bureau 3F.50, Montreal, Quebec H4A 3S5

Contact Name: nandini.dendukuri@mcgill.ca

Contact Email: nandini.dendukuri@mcgill.ca

Copyright: Technology Assessment Unit of the McGill University Health Centre (MUHC)