A Study on Palliation of Carcinoma of Oesophagus with Self Expandable Metal Stent.

Karthikeyan, R (2006) A Study on Palliation of Carcinoma of Oesophagus with Self Expandable Metal Stent. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

INTRODUCTION : Carcinoma of oesophagus is one of the most debilitating disease that deprives a person from the joy of eating food. It frustrates the patient because of the mechanical effect resulting in dysphagia and infiltration to the nearby structures resulting in excruciating pain. When the tumour extends into respiratory tract further worsens the nutritional status by aggravating the dysphagia cough and aspiration on swallowing and associated respiratory infection and negative nitrogen balance add to the problem. At the time of presentation of symptoms most of the patients are in advanced malignancy. Unfortunately this disease is increasing in our country due to the changing trends in people’s lifestyle and food habits. AIM OF THE STUDY : 1. To study the role of Self Expandable Metal Stents for Palliation in Cancer Oesophagus patients. 2. To study the effectiveness of Self Expandable Metal Stents in oesophago-respiratory fistula associated with Cancer Oesophagus. 3. To study the procedural success of placement of Self Expandable Metal Stent in Patients with Carcinoma of the Oesophagus. 4. To study the complications following Self Expandable Metal Stent placement for carcinoma of the oesophagus. 5. To study the effect of placing Self Expandable Metal Stent without Antireflux Valve across the Oesophagogastric Junction. 6. To study the effect of placing Self Expandable Metal Stent in the upper Oesophageal tumours within 2 cm of upper Oesophageal Sphincter. MATERIALS AND METHODS : This study was conducted in Department of Digestive Health & Diseases a prestigious department with rich heritage located in the Government Peripheral Hospital, Anna Nagar, Chennai- 600 102, attached to Government Kilpauk Medical College, Chennai. The study conducted exclusively in Department of Digestive Health & Diseases inpatients and the patients were subsequently followed as out patients. The Study period was May 2003 to August 2005. The patients belonged to two groups. First group patients were referred from other hospitals. Department of Digestive Health & Diseases is the referral center to Government Kilpauk Medical College Hospital, Chennai; Government Royapettah Hospital, Royapettah, Chennai; ESI Hospital in Ayanavaram, Chennai; ESI Hospital in KK Nagar, Chennai; Government Peripheral Hospital, Periyar Nagar, Chennai; Government Chest Hospital, Ooteri and many Government Institutions all over the State. Second group of patients presented themselves to Department of Digestive Health & Diseases due to their GI symptoms. CONCLUSION : 1. Self Expandable Metal Stents for Palliation in Carcinoma Oesophagus gives excellent relief of dysphagia and provides good quality of life to these patients. There is improvement in general well being by allowing the patient to eat and offers better aesthetic appeal. 2. Self Expandable Metal Stents in oesophago-respiratory fistula completely covers the fistula immediately after the procedure. It improves the general condition, controls respiratory infection, improves the nutritional state and offers good quality of life in these patients with Carcinoma Oesophagus. 3. Procedural success of deploying Self Expandable Metal Stent in patients with Carcinoma of Oesophagus is good. It is very convenient and easy to deploy the stent and is less cumbersome too. Excellent expansion of the stent occurs immediately after deploying and relieves the dysphagia in the immediate post procedure period. 4. Complications following proper placement of Self Expandable Metal Stents for carcinoma oesophagus are minimal but they are well managed. No major immediate post stenting complications occurred in my study. Expected number of late complications in the form of stent blockage and stent migration occurred but they were managed well. 5. There is no increase in the incidence of reflux symptoms in the group where stents without any anti reflux mechanism are placed across the Oesophagogastric Junction. 6. There are only minor complications in the form of choking sensation when the Self Expandable Metal Stent properly placed in the upper Oesophageal Lesion within 2 cm of upper Oesophageal Sphincter.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Palliation ; Carcinoma of Oesophagus ; Self Expandable Metal Stent.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 14 Jul 2017 02:44
Last Modified: 14 Jul 2017 02:44
URI: http://repository-tnmgrmu.ac.in/id/eprint/1598

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