A prospective phase II evaluation of esophageal stenting for neoadjuvant therapy for XXXX : optimal performance and surgical safety.

@entity1 @entity353 @entity1151 @entity418 @entity3 @entity1282 @entity130
BACKGROUND: Many surgeons are reluctant to use esophageal stents during neoadjuvant therapy for @entity418 because of concerns about nutritional status, stent-related complications, or added difficulties during esophagogastrectomy. We hypothesized that esophageal stenting during neoadjuvant therapy allows for optimal nutritional intake without adversely affecting perioperative outcomes. STUDY DESIGN: This study is a prospective, dual-institution, single-arm, phase II evaluation of @entity418 @entity1 undergoing neoadjuvant therapy before resection. All @entity1 had a self-expanding polymer stent placed before neoadjuvant therapy. We monitored @entity1282 symptoms, nutritional status, stent-related complications, and perioperative complications during the course of therapy and 90 days postoperatively. RESULTS: We enrolled 32 @entity1 with @entity1282 and @entity353 who were eligible for neoadjuvant therapy. After stent placement, 2 @entity1 had stent migrations requiring replacement. No erosive complications were observed. During the course of neoadjuvant therapy, we noted improvement in @entity1282 , mild @entity353 , and maintenance of performance status. At a median of 50 days (range 18 to 92 days) after completion of neoadjuvant therapy, 20 @entity1 underwent margin-negative esophagogastrectomy (16 Ivor Lewis, 4 minimally invasive) without problems with stent removal or difficulty in surgical dissection. Twelve @entity1 did not undergo resection due to development of @entity3 (n = 8) or rapid decline in functional status (n = 4). Major perioperative complications included @entity1151 (n = 2), chyle leak (n = 1), and @entity130 (n = 1). No surgical complications were attributed to stent placement. CONCLUSIONS: Use of esophageal stents during neoadjuvant therapy is safe and results in resolution of @entity1282 , mild @entity353 , and maintenance of performance status without an effect on intraoperative dissection, perioperative complications, or delay in resection after neoadjuvant therapy.
