High pharyngoesophageal strictures after laryngopharyngectomy can also be treated by self-expandable plastic stents

• Published in: Gastrointestinal endoscopy Vol. 71; no. 7; pp. 1304 - 1307
• Main Authors: Somani, Sanjay Kumar, MD, DM, Verma, Narinder, MS, Avasthi, Gurcharan, MD, Ghosh, Arindam, MS, MCh, Goyal, Richa, MD, DNB, Joshi, Nitin, MS
• Format: Journal Article
• Language: English
• Published: Maryland heights, MO Mosby, Inc 01.06.2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Coated Materials, Biocompatible; Digestive system. Abdomen; Endoscopy; Esophageal Stenosis - diagnosis; Esophageal Stenosis - etiology; Esophageal Stenosis - surgery; Female; Follow-Up Studies; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Laryngeal Neoplasms - surgery; Laryngectomy - adverse effects; Laryngostenosis - diagnosis; Laryngostenosis - etiology; Laryngostenosis - surgery; Male; Medical sciences; Middle Aged; Pharyngectomy - adverse effects; Prosthesis Design; Prosthesis Implantation - methods; Retrospective Studies; Stents; Treatment Outcome; self-expandable plastic stent; SEPS; Stenosis; Instrumentation therapy; Pharyngoesophageal; Stent
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2009.12.050

Background Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent insertion of self-expandable plastic stents (SEPSs) across the stricture for treatment of dysphagia. Objective The aim of this study was to evaluate the role of SEPSs in postlaryngopharyngectomy strictures. Design An interventional study of management of 4 patients of dysphagia after laryngopharyngectomy with SEPSs. Setting Medical gastroenterology unit in a tertiary care hospital. Patients Four patients with dysphagia after laryngopharyngectomy. Interventions SEPS placement and removal after 3 months. Main Outcome Measurements Improvement in dysphagia. Methods Four patients with dysphagia after laryngopharyngectomy underwent dilation of stricture followed by SEPS placement for 3 months. Results Three patients had grade IV, and 1 grade III dysphagia. Endoscopy showed stricture at 10 to 14 cm from the incisors. Stricture was dilated up to 15 mm on 3 occasions, 2 weeks apart. A silicone Polyflex stent was placed across the stricture and removed after 3 months. No dysphagia recurred after 2 months. No significant complications were noted. Limitations Small sample size. Conclusions SEPSs dilate postlaryngopharyngectomy strictures and prevent restenosis even after removal.