| Abstract [eng] |
Introduction: Esophageal cancer remains one of the malignancies with the highest mortality and is often diagnosed at advanced stages, therefore many patients require palliative treatment. Esophageal stenting is a widely used minimally invasive method for relieving dysphagia. However, it is associated with a significant risk of complications, particularly when combined with chemoradiotherapy. Aim: To evaluate complications of esophageal stenting, their risk factors, and management options in the treatment of esophageal cancer. Objectives: (1) to review the evolution, types, and indications of esophageal stenting; (2) to assess complications and their contributing factors; (3) to determine management and prevention strategies for these complications. Methods: The study is based on a retrospective analysis of a single clinical case and a narrative review of the scientific literature. The clinical case was analyzed based on medical records, evaluating disease course, applied treatment, developed complications, and clinical outcomes. The literature review included articles published between 2016 and 2026 in the PubMed database, as well as international clinical guidelines. Results: A 47-year-old female patient with lower esophageal squamous cell carcinoma underwent esophageal stenting due to malignant stricture and received chemoradiotherapy. Subsequently, in the absence of tumor progression, an esophagobronchial fistula, recurrent aspiration pneumonia, and progressive esophageal obstruction developed. Due to ineffective endoscopic management, complex surgical treatment was required, including staged esophagectomy with pulmonary lobectomy. Despite a complicated postoperative course, long-term clinical stabilization was achieved, with improvement in nutritional status and no evidence of disease progression. The literature review showed that stenting effectively relieves dysphagia. However, complications remain frequent. The most common complications include stent migration, obstruction, bleeding, and fistula formation, while the main risk factors are chemoradiotherapy, duration of stent placement, tumor regression, and stent mechanical properties. Conclusions: Esophageal stenting is an effective method for relieving dysphagia but is associated with a significant risk of complications, particularly late ones. In patients undergoing chemoradiotherapy or radical treatment and with longer expected survival, indications for stenting should be individualized, taking into account the risk of complications and alternative nutritional support strategies. Further prospective studies are needed to optimize patient selection and reduce the incidence of complications. |
