Palliative Esophageal Stenting in Advanced Esophageal Carcinoma: Experience from 80 Cases in Northern Bangladesh

Abstract

Background: Esophageal carcinoma is a major health burden in Bangladesh, frequently diagnosed at advanced, inoperable stages. In such patients, palliation of malignant dysphagia is a key therapeutic goal. Self-expanding metal stents (SEMS) offer rapid relief, yet data from larger Bangladeshi cohorts remain limited.

Objective: To evaluate the clinical outcomes, complication profile, and survival following SEMS placement for palliation of inoperable esophageal carcinoma in Northern Bangladesh.

Materials & Methods: A retrospective analysis was conducted on 80 consecutive patients undergoing SEMS placement over a period of 05 years at selected endoscopy centers of northern Bangladesh. Data on demographics, tumor characteristics, pre- and post-stent dysphagia scores, complications, and survival were analyzed. Dysphagia was scored from 0 (normal diet) to 4 (complete dysphagia) at bascline, 1 week, and I month.

Results: The cohort comprised 48 men (60%) and 32 women (40%), mean age 62.5 years. Squamous cell carcinoma predominated (65%), with the lower esophagus most frequently affected (55%). Baseline mean dysphagia score was 3.2+ 0.5, improving to 1.1+0.7 at 1 week and 1.0+ 0.8 at 1 month post-stent (p < 0.001); 90% achieved a score <1 by 1 month. Complications occurred in 28 patients (35%), including chest pain >48 h (20%), stent migration (8.75%), blockage (7.5%), and bleeding requiring intervention (3.75%). No procedure-related mortality was observed. Median survival was 192 days (range: 28-480), with 56.25% surviving beyond 6 months.

Conclusion: SEMS placement provides rapid, significant, and sustained relief of dysphagia in patients with inoperable esophageal carcino- ma, with low immediate risk and manageable complications, offering tangible quality-of-life improvements within the limited survival period.