La protesi di Atkinson nella terapia endoscopica palliativa delle stenosi neoplastiche esofago-cardiali

Seventy-two consecutive patients with malignant and unresectable cardio-esophageal stenosis, were treated by endoscopic insertion of Atkinson prosthesis. Post-intubation mortality rate (within 30 days) was 8.3% (6 patients); early procedure related complications were 7 (9.7%): 1 perforation of the esophagus, 1 perforation of the stomach, 1 aspiration pneumonia and 4 dislocations of the prosthesis; none of these 7 died during the post-intubation period. Relief of dysphagia occurred in 100% of patients; satisfactory oral feeding was achieved in all patients but 6 with very advanced diseases. Late complications occurred in 17 patients out of 61 with a complete follow-up (27.8%): 7 food obstructions, 6 obstructions due to neoplastic overgrowth, 3 dislocations and 1 compression of the prosthesis. Average survival was 3.6 months (range 1-12). In our experience, endoscopic insertion of Atkinson prosthesis has shown to be a safe and effective procedure in the treatment of malignant and unresectable cardio-esophageal stenosis.