grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2025-184-2-33-42grekov-2546Research ArticleВОПРОСЫ ОБЩЕЙ И ЧАСТНОЙ ХИРУРГИИPROBLEMS OF GENERAL AND SPECIAL SURGERYСтентирование при дисфагии на фоне рецидивов злокачественных опухолейStenting for dysphagia due to recurrent malignant tumorshttps://orcid.org/0000-0002-2554-2223ИвановА. И.IvanovA. I.

Иванов Алексей Игоревич, кандидат медицинских наук, доцент кафедры эндоскопии, общей и эндоскопической хирурги, Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования», зав. отделением эндоскопии, Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан имени профессора М. З. Сигала, доцент кафедры фундаментальных основ клинической медицины, Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования», главный внештатный эндоскопист РТ

420029, г. Казань, ул. Сибирский тракт, д. 29,

420008, г. Казань, ул. Кремлевская, д. 18,

420012, г. Казань, ул. Бутлерова, д. 36

Ivanov Aleksej I., Cand. of Sci. (Med.), Associate Professor of the Department of Endoscopy, General and Endoscopic Surgery, Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuous Professional Education, Head of the Department of Endoscopy, Republican Clinical Oncology Dispensary named after Prof. M. Z. Sigal, Associate Professor of the Department of Fundamentals of Clinical Medicine, Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuous Professional Education (Kazan, Russia), Chief Endoscopist of the Republic of Tatarstan

29, Sibirskii trakt, Kazan, 420029, 

18, Kremlevskaia str., Kazan, 420008, 

36, Butlerova str., Kazan, 420012

https://orcid.org/0000-0003-0998-4547ПоповВ. А.PopovV. A.

Попов Владимир Альбертович, врач-эндоскопист отделения эндоскопии, научный сотрудник научно-исследовательского отдела

420064, г. Казань, Оренбургский тракт, д. 138

Popov Vladimir A., Endoscopist of the Department of Endoscopy, Research Fellow of the Research Department

138, Orenburg tract, Kazan, 420064

lyapac@mail.ruhttps://orcid.org/0000-0002-5334-6481БурмистровМ. В.BurmistrovM. V.

Бурмистров Михаил Владимирович, доктор медицинских наук, профессор кафедры онкологии, радиологии и паллиативной медицины, Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» (г. Казань, Россия), зав. кафедрой хирургических болезней последипломного образования ИФМиБ, Казанский (Приволжский) федеральный университет

420064, г. Казань, Оренбургский тракт, д. 138,

420008, г. Казань, ул. Кремлевская, д. 18

Burmistrov Mihail V., Dr. of Sci. (Med.), Professor of the Department of Oncology, Radiology and Palliative Medicine, Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuous Professional Education, Head of the Department of Surgical Diseases of Postgraduate Education of the Institute of Fundamental Medicine and Biology

138, Orenburg tract, Kazan, 420064,

18, Kremlevskaia str., Kazan, 420008

https://orcid.org/0000-0003-1442-0885НазмеевМ. А.NazmeevM. A.

Назмеев Марат Альбертович, зав. отделением эндоскопии, научный сотрудник научно-исследовательского отдела

420064, г. Казань, Оренбургский тракт, д. 138

Nazmeev Marat A., Head of the Department of Endoscopy, Research Fellow of the Research Department

138, Orenburg tract, Kazan, 420064

Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан имени профессора М. З. Сигала; Казанский (Приволжский) федеральный университет; Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования»РоссияRepublican Clinical Oncology Dispensary named after Prof. M. Z. Sigal; Kazan (Volga Region) Federal University; Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuous Professional EducationRussian FederationРеспубликанская клиническая больница Минздрава Республики ТатарстанРоссияRepublican Clinical HospitalRussian FederationРеспубликанская клиническая больница Минздрава Республики Татарстан; Казанский (Приволжский) федеральный университетРоссияRepublican Clinical Hospital; Kazan (Volga Region) Federal UniversityRussian Federation20252706202518423342Copyright © Иванов А.И., Попов В.А., Бурмистров М.В., Назмеев М.А., 20252025Иванов А.И., Попов В.А., Бурмистров М.В., Назмеев М.А.Ivanov A.I., Popov V.A., Burmistrov M.V., Nazmeev M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2546Введение

Введение. Стентирование при рецидивах рака пищевода и желудка с целью разрешения возникшей дисфагии является достаточно редким вмешательством. Научные публикации, посвященные этому вопросу, встречаются очень редко. ЦЕЛь. Анализ эффективности, осложнений и продолжительности жизни после стентирования пищеводными стентами у больных с рецидивом рака пищевода и желудка после оперативных вмешательств.

Методы и материалы

Методы и материалы. Саморасправляющиеся металлические пищеводные стенты были установлены под видеоэндоскопическим контролем 45 пациентам с дисфагией на фоне рака пищевода и желудка за период с 2013 по 2023 г. на базе Республиканского клинического онкологического диспансера Минздрава Республики Татарстан им М. з. Сигала.

Результаты

Результаты. Осложнений непосредственно во время вмешательства не наблюдалось. Показатели дисфагии уменьшились в среднем на 2 балла. В раннем и отдаленном периоде осложнения возникли в 16 случаях (36 %), среди них миграция стента, продолженный рост опухолевой ткани, грануляционная стриктура, деформация стента и болевой синдром. Неэффективность стентирования в связи с невозможностью эндоскопического разрешения возникших осложнений отмечена в 3 случаях (19 % от общего количества осложнений). Средняя продолжительность жизни составила 128 дней.

Заключение

Заключение. Стентирование у этой категории больных является достаточно эффективным способом разрешения дисфагии в короткие сроки, но осложнения встречаются достаточно часто и не все из них поддаются эндоскопическим способам разрешения.

Introduction

Introduction. Stenting for recurrent esophageal and gastric cancer to resolve dysphagia is a relatively rare intervention. Scientific publications devoted to this issue are very rare.

The objective was to analyze the effectiveness, complications and life expectancy after esophageal stenting in patients with recurrent esophageal and gastric cancer after surgery.

Methods and materials

Methods and materials. Self-expanding metal esophageal stents were installed under videoendoscopic control in 45 patients with dysphagia due to esophageal and gastric cancer, for the period from 2013 to 2023, at the Republican Clinical Oncology Dispensary of the Ministry of Health of the Republic of Tatarstan named after M. Z. Sigal. RESULTS. There were no complications directly during the intervention. Dysphagia indicators decreased by an average of 2 points. In the early and late periods, complications arose in 16 cases (36 %), including stent migration, continued tumor tissue growth, granulation stricture, stent deformation, and pain syndrome. Ineffectiveness of stenting due to the impossibility of endoscopic resolution of the complications that arose was noted in three cases (19 % of the total number of complications). The average survival time was 128 days.

Conclusion

Conclusion. Stenting in this category of patients is a fairly effective way to resolve dysphagia in a short time, but complications are quite common and not all of them can be resolved by endoscopic methods.

стентированиедисфагиярецидив ракаанастомозрак пищеводарак желудкаstentingdysphagiacancer recurrenceanastomosisesophageal cancergastric cancerReferencesHulscher J. B. F., Sandic J. W., Tijssen J. G. P et al. The recurrence pattern of esophageal carcinoma after transhiatal resection. J. Am Coll Surg. 2000. Vol. 191. P. 143–148. https://doi.org/10.1016/S1072-7515(00)00349-5.Hulscher J. B. F., Sandic J. W., Tijssen J. G. P et al. The recurrence pattern of esophageal carcinoma after transhiatal resection. J. Am Coll Surg. 2000;191:143–148. https://doi.org/10.1016/S1072-7515(00)00349-5.Kato H., Tachimori Y., Watanabe H. et al. Anastomotic recurrence of esophageal squamous cell carcinoma after transthoracic esophagectomy. Eur J. Surg. 1998. Vol. 164. P. 759–764.Kato H., Tachimori Y., Watanabe H. et al. Anastomotic recurrence of esophageal squamous cell carcinoma after transthoracic esophagectomy. Eur J. Surg. 1998;164:759–764.Parshad R., Singh R. K., Kumar A. et al. Adenocarcinoma of distal esophagus and gastroesophageal junction: Long-term results of surgical treatment in a north indian center. World J. Surg. 1999. Vol. 23. P. 277–283. https://doi.org/10.1007/PL00013179.Parshad R., Singh R. K., Kumar A. et al. Adenocarcinoma of distal esophagus and gastroesophageal junction: Long-term results of surgical treatment in a north indian center. World J. Surg. 1999;23:277–283. https://doi.org/10.1007/PL00013179.Sanz L., Gonzalez J. J., Miyar A. et al. Pattern of recurrence after esophageal resection for cancer. Hepatogastroenterology. 1999. Vol. 46. P. 2393–2397.Sanz L., Gonzalez J. J., Miyar A. et al. Pattern of recurrence after esophageal resection for cancer. Hepatogastroenterology. 1999;46:2393–2397.Hoksch B., Müller J. M. Surgical manage ment of locoregional recurrence of gastric carcinoma. Zentralbl Chir. 1999. Vol. 124. P. 1087–1090.Hoksch B., Müller J. M. Surgical manage ment of locoregional recurrence of gastric carcinoma. Zentralbl Chir. 1999;124:1087–1090.Shiraishi N., Inomata M., Osawa N. et al. Early and late recurrence after gastrectomy for gastric carcinoma.Univariate analysis. Cancer. 2000. Vol. 89. P. 255–261. https://doi.org/10.1002/1097-0142(20000715)89:23.0.CO;2-N.Shiraishi N., Inomata M., Osawa N. et al. Early and late recurrence after gastrectomy for gastric carcinoma.Univariate analysis. Cancer. 2000;89:255–261. https://doi.org/10.1002/1097-0142(20000715)89:2<255::AID-CNCR8>3.0.CO;2-N.Böhner H., Zimmer T. H., Hopfenmüller W. et al. Detection and prognosis of recurrent gastric cancer – is routine follow-up after gastrectomy worthwhile? Hepatogastroenterol. 2000. Vol. 47. P. 1489–1494.Böhner H., Zimmer T. H., Hopfenmüller W. et al. Detection and prognosis of recurrent gastric cancer – is routine follow-up after gastrectomy worthwhile? Hepatogastroenterol. 2000;47:1489–1494.Schumacher I. K., Hunsicker A., Petermann J., Lorenz D. Magenkarzinomchirurgie – Bewährtes und Kontroverses. Chirurg. 1999. Vol. 70. P. 1447–1453. https://doi.org/10.1007/s001040050085.Schumacher I. K., Hunsicker A., Petermann J., Lorenz D. Magenkarzinomchirurgie – Bewährtes und Kontroverses. Chirurg. 1999;70:1447–1453. https://doi.org/10.1007/s001040050085.Yoo C. H., Noh S. H., Shin D. W. et al. Recurrence following curative resection for gastric carcinoma. Br J. Surg. 2000. Vol. 87. P. 236–242. https://doi.org/10.1046/j.1365-2168.2000.01360.x.Yoo C. H., Noh S. H., Shin D. W. et al. Recurrence following curative resection for gastric carcinoma. Br J. Surg. 2000;87:236–242. https://doi.org/10.1046/j.1365-2168.2000.01360.x.Kaibara N., Sumi K., Yonekawa M. et al. Does extensive dissection of lymph nodes improve the results of surgical treatment of gastric cancer? Am J. Surg. 1990. Vol. 159. P. 218–221. https://doi.org/10.1016/S0002-9610(05)80265-X.Kaibara N., Sumi K., Yonekawa M. et al. Does extensive dissection of lymph nodes improve the results of surgical treatment of gastric cancer? Am J. Surg. 1990;159:218–221. https://doi.org/10.1016/S0002-9610(05)80265-X.Telford J. J., Carr-Locke D. L., Baron T. H. et al. Palliation of patients with malignant gastric outlet obstruction with the enteral Wallstent: outcomes from a multicenter study. Gastrointest Endosc. 2004. Vol. 60. P. 916‒20. https://doi.org/10.1016/S0016-5107(04)02228-X.Telford J. J., Carr-Locke D. L., Baron T. H. et al. Palliation of patients with malignant gastric outlet obstruction with the enteral Wallstent: outcomes from a multicenter study. Gastrointest Endosc. 2004;60:916‒20. https://doi.org/10.1016/S0016-5107(04)02228-X.Dormann A., Meisner S., Verin N. et al. Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy. 2004. Vol. 36. P. 543‒50. https://doi.org/10.1055/s-2004-814434.Dormann A., Meisner S., Verin N. et al. Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy. 2004;36:543‒50. https://doi.org/10.1055/s-2004-814434.Thompson A. M., Rapson T., Gilbert F. J. et al. Endoscopic palliative treatment for esophageal and gastric cancer: techniques, complications, and survival in a population-based cohort of 948 patients. Surg Endosc. 2004. Vol. 18. P. 1257‒62. https://doi.org/10.1007/s00464-003-9256-9.Thompson A. M., Rapson T., Gilbert F. J. et al. Endoscopic palliative treatment for esophageal and gastric cancer: techniques, complications, and survival in a population-based cohort of 948 patients. Surg Endosc. 2004;18:1257‒62. https://doi.org/10.1007/s00464-003-9256-9.Kim G. H., Kang D. H., Lee D. H. et al. Which types of stent, uncovered or covered, should be used in gastric outlet obstructions? Scand J Gastroenterol 2004. Vol. 39. P. 1010‒4.Kim G. H., Kang D. H., Lee D. H. et al. Which types of stent, uncovered or covered, should be used in gastric outlet obstructions? Scand J Gastroenterol 2004;39:1010‒4.Maetani I., Inoue H., Sato M. et al. Peroral insertion techniques of selfexpanding metal stents for malignant gastric outlet and duodenal stenoses. Gastrointest Endosc. 1996. Vol. 44. P. 468‒71. https://doi.org/10.1080/00365520410003146.Maetani I., Inoue H., Sato M. et al. Peroral insertion techniques of selfexpanding metal stents for malignant gastric outlet and duodenal stenoses. Gastrointest Endosc. 1996;44:468‒71. https://doi.org/10.1080/00365520410003146.Nevitt A. W., Vida F., Kozarek R.A. et al. Expandable metallic prostheses for malignant obstruction of gastric outlet and proximal small bowel. Gastrointest Endosc. 1998. Vol. 47. P. 271‒6. https://doi.org/10.1016/S0016-5107(98)70326-8.Nevitt A. W., Vida F., Kozarek R. A. et al. Expandable metallic prostheses for malignant obstruction of gastric outlet and proximal small bowel. Gastrointest Endosc. 1998;47:271‒6. https://doi.org/10.1016/S0016-5107(98)70326-8.Bethge N., Breiktuetz C., Vakil N. Metal stents for the palliation of inoperable upper gastrointestinal stenoses. Am J. Gastroenterol 1998. Vol. 93. P. 643‒5. https://doi.org/10.1111/j.1572-0241.1998.182_b.x.Bethge N., Breiktuetz C., Vakil N. Metal stents for the palliation of inoperable upper gastrointestinal stenoses. Am J. Gastroenterol 1998;93:643‒5. https://doi.org/10.1111/j.1572-0241.1998.182_b.x.Adler D. G., Baron T. H. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J. Gastroenterol. 2002. Vol. 97. P. 72‒8. https://doi.org/10.1111/j.1572-0241.2002.05423.x.Adler D. G., Baron T. H. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J. Gastroenterol. 2002;97:72‒8. https://doi.org/10.1111/j.1572-0241.2002.05423.x.Jeong J. Y., Han J. K., Kim A. Y. et al. Fluoroscopically guided placement of a covered self-expandable metallic stent for malignant antroduodenal obstructions: preliminary results in 18 patients. AJR Am J. Roentgenol. 2002. Vol. 178. P. 847‒852. https://doi.org/10.2214/ajr.178.4.1780847.Jeong J. Y., Han J. K., Kim A. Y. et al. Fluoroscopically guided placement of a covered self-expandable metallic stent for malignant antroduodenal obstructions: preliminary results in 18 patients. AJR Am J. Roentgenol. 2002;178:847‒852. https://doi.org/10.2214/ajr.178.4.1780847.Bal M. S., Bodal V. K., Kaur J. et al. Patterns of Cancer: A Study of 500 Punjabi Patients. Asian Pac J. Cancer Prev. 2015. Vol. 16, № 12. P. 5107–10. https://doi.org/10.7314/apjcp.2015.16.12.5107.Bal M. S., Bodal V. K., Kaur J. et al. Patterns of Cancer: A Study of 500 Punjabi Patients. Asian Pac J. Cancer Prev. 2015;16(12):5107–10. https://doi.org/10.7314/apjcp.2015.16.12.5107.Alsop B. R., Sharma P. Esophageal cancer. Gastroenterol Clin North Am. 2016. Vol. 45, № 3. P. 399–412. https://doi.org/10.1016/j.gtc.2016.04.001.Alsop B. R., Sharma P. Esophageal cancer. Gastroenterol Clin North Am. 2016;45(3):399–412. https://doi.org/10.1016/j.gtc.2016.04.001.Wong S. K., Chiu P. W., Leung S. F. et al. Concurrent chemoradiotherapy or endoscopic stenting for advanced squamous cell carcinoma of esophagus: A case-control study. Ann Surg Oncol. 2008. Vol. 15. P. 576–582. https://doi.org/10.1245/s10434-007-9679-y.Wong S. K., Chiu P. W., Leung S. F. et al. Concurrent chemoradiotherapy or endoscopic stenting for advanced squamous cell carcinoma of esophagus: A case-control study. Ann Surg Oncol. 2008;15:576–582. https://doi.org/10.1245/s10434-007-9679-y.Adler D. G., Baron T. H. Endoscopic palliation of malignant dysphagia. Mayo Clin Proc. 2001. Vol. 76. P. 731–738. https://doi.org/10.4065/76.7.731.Adler D. G., Baron T. H. Endoscopic palliation of malignant dysphagia. Mayo Clin Proc. 2001;76:731–738. https://doi.org/10.4065/76.7.731.Loser C., Wolters S., Folsch U. R. Enteral long-term nutrition via percutaneous endoscopic gastrostomy (PEG) in 210 patients: a four-year prospective study. Dig Dis Sci. 1998. Vol. 43. P. 2549–2557. https://doi.org/10.1023/A:1026615106348.Loser C., Wolters S., Folsch U. R. Enteral long-term nutrition via percutaneous endoscopic gastrostomy (PEG) in 210 patients: a fouryear prospective study. Dig Dis Sci. 1998;43:2549–2557. https://doi.org/10.1023/A:1026615106348.Ljungdahl M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial. Surg Endosc. 2006. Vol. 20, № 8. P. 1248‒51. https://doi.org/10.1007/s00464-005-0757-6.Ljungdahl M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial. Surg Endosc. 2006;20(8):1248‒51. https://doi.org/10.1007/s00464-005-0757-6.Bergstrom L. R., Larson De, Zinsmeister A. R. et al. Utilization and outcomes of surgical gastrostomies and jejunostomies in an era of percutaneous endoscopic gastrostomy: a population-based study. Mayo Clm Proc. 1995. Vol. 70, № 9. P. 829‒36.Bergstrom L. R., Larson De, Zinsmeister A. R. et al. Utilization and outcomes of surgical gastrostomies and jejunostomies in an era of percutaneous endoscopic gastrostomy: a population-based study. Mayo Clm Proc. 1995;70(9):829‒36.Мамонтов А. С., Соколов В. В., Верещагин В. Г. Лечебная тактика при нерезектабельном раке пищевода с дисфагией II–IV степени: обходное шунтирование, гастростомия или эндопротезирование? Паллиативная медицина и реабилитация. 2003. № 2. С. 88–89.Mamontov A. S., Sokolov V. V., Vereshchagin V. G. Treatment strategy for unresectable esophageal cancer with grade II–IV dysphagia: bypass surgery, gastrostomy or endoprosthetics? Palliative Medicine and Rehabilitation. 2003;(2):88–89. (In Russ.).Patton J. T., Carter R. Endoscopic stenting for recurrent malignant gastric outlet obstruction. Br J. Surg. 1997. Vol. 84. P. 865‒6.Patton J. T., Carter R. Endoscopic stenting for recurrent malignant gastric outlet obstruction. Br J. Surg. 1997;84:865‒6.Wayman J., Bliss R., Richardson D. L. et al. Self-expanding metal stents in the palliation of small bowel stenosis secondary to recurrent gastric cancer. Gastrointest Endosc. 1998. Vol. 47. P. 286‒90.Wayman J., Bliss R., Richardson D. L. et al. Self-expanding metal stents in the palliation of small bowel stenosis secondary to recurrent gastric cancer. Gastrointest Endosc. 1998;47:286‒90.Jeong J. Y., Kim Y. J., Han J. K. et al. Palliation of anastomotic obstructions in recurrent gastric carcinoma with the use of covered metallic stents: clinical results in 25 patients. Surgery. 2004. Vol. 135. P. 171‒7.Jeong J. Y., Kim Y. J., Han J. K. et al. Palliation of anastomotic obstructions in recurrent gastric carcinoma with the use of covered metallic stents: clinical results in 25 patients. Surgery. 2004;135:171‒7.Cheung H. Y., Chung S. C. Covered metal stent for tumor obstruction of efferent loop recurrence after gastrectomy. Surg Endosc. 1997. Vol. 11. P. 936‒8.Cheung H. Y., Chung S. C. Covered metal stent for tumor obstruction of efferent loop recurrence after gastrectomy. Surg Endosc. 1997;11:936‒8.Sherwood P., Duggan A., Shek F. et al. Esophagojejunal stenting for recurrent gastric carcinoma. Gastrointest Endosc. 1998. Vol. 47. P. 192‒4.Sherwood P., Duggan A., Shek F. et al. Esophagojejunal stenting for recurrent gastric carcinoma. Gastrointest Endosc. 1998;47:192‒4.Lee J. M., Han Y. M., Lee S. Y. et al. Palliation of postoperative gastrointestinal anastomotic malignant strictures with flexible covered metallic stents: preliminary results. Cardiovasc Intervent Radiol. 2001. Vol. 24. P. 25‒30.Lee J. M., Han Y. M., Lee S. Y. et al. Palliation of postoperative gastrointestinal anastomotic malignant strictures with flexible covered metallic stents: preliminary results. Cardiovasc Intervent Radiol. 2001;24:25‒30.Kim H. J., Park J.Y., Bang S. et al. Self-expandable metal stents for recurrent malignant obstruction after gastric surgery. Hepatogastroenterology. 2009. Vol. 56, № 91‒92. P. 914‒7.Kim H. J., Park J.Y., Bang S. et al. Self-expandable metal stents for recurrent malignant obstruction after gastric surgery. Hepatogastroenterology. 2009;56(91‒92):914‒7.Cho Y. K., Kim S. W., Nam K. W. et al. Clinical outcomes of self-expandable metal stents in palliation of malignant anastomotic strictures caused by recurrent gastric cancer. World J. Gastroenterol. 2009. Vol. 28. Vol. 15, № 28. P. 3523‒7.Cho Y. K., Kim S. W., Nam K. W. et al. Clinical outcomes of self-expandable metal stents in palliation of malignant anastomotic strictures caused by recurrent gastric cancer. World J. Gastroenterol. 2009;28;15(28):3523‒7.Verschuur E. M., Steyerberg E. W., Kuipers E. J., Siersema P. D. Effect of stent size on complications and recurrent dysphagia in patients with esophageal or gastric cardia cancer. Gastrointest. Endoscopy. 2007. Vol. 65б, № 4. P. 592–601. https://doi.org/10.1016/j.gie.2006.12.018.Verschuur E. M., Steyerberg E. W., Kuipers E. J., Siersema P. D. Effect of stent size on complications and recurrent dysphagia in patients with esophageal or gastric cardia cancer. Gastrointest. Endoscopy. 2007;65(4):592–601. https://doi.org/10.1016/j.gie.2006.12.018.Song G. A., Kang D. H., Kim T. O. et al. Endoscopic stenting in patients with recurrent malignant obstruction after gastric surgery: uncovered versus simultaneously deployed uncovered and covered (double) selfexpandable metal stents. Gastrointest Endosc. 2007. Vol. 65, № 6. P. 782‒7. https://doi.org/10.1016/j.gie.2006.08.030.Song G. A., Kang D. H., Kim T. O. et al. Endoscopic stenting in patients with recurrent malignant obstruction after gastric surgery: uncovered versus simultaneously deployed uncovered and covered (double) selfexpandable metal stents. Gastrointest Endosc. 2007;65(6):782‒7. https://doi.org/10.1016/j.gie.2006.08.030.Sharma P., Kozarek R. Practice Parameters Committee of American College of Gastroenterology Role of esophageal stents in benign and malignant diseases. Am. J. Gastroenterol. 2010. Vol. 105. P. 258–273. https://doi.org/10.1038/ajg.2009.684.Sharma P., Kozarek R. Practice Parameters Committee of American College of Gastroenterology Role of esophageal stents in benign and malignant diseases. Am. J. Gastroenterol. 2010;105:258–273. https://doi.org/10.1038/ajg.2009.684.Siersema P. D., Hop W. C., van Blankenstein M. et al. A comparison of 3 types of covered metal stents for the palliation of patients caused by esophagogastric carcinoma: a prospective, randomized study. Gastrointest. Endosc. 2001. Vol. 54. P. 145–153. https://doi.org/10.1067/mge.2001.116879.Siersema P. D., Hop W. C., van Blankenstein M. et al. A comparison of 3 types of covered metal stents for the palliation of patients caused by esophagogastric carcinoma: a prospective, randomized study. Gastrointest. Endosc. 2001;54:145–153. https://doi.org/10.1067/mge.2001.116879.Wlodarczyk J., Kuzdzal J. Stenting as a palliative method in the management of advanced squamous cell carcinoma of the oesophagus and gas tro-oesophageal junction. Wideochirurgia i inne techniki maloinwazyjne. 2016. Vol. 11, № 1. P. 1–8. https://doi.org/10.5114/wiitm.2016.58979.Wlodarczyk J., Kuzdzal J. Stenting as a palliative method in the management of advanced squamous cell carcinoma of the oesophagus and gastro-oesophageal junction. Wideochirurgia i inne techniki maloinwazyjne. 2016;11(1):1–8. https://doi.org/10.5114/wiitm.2016.58979.Bor R., Fabian A., Balint A. et al. Endoscopic management of complications of self-expandable metal stents for treatment of malignant esophageal stenosis and tracheoesophageal fistulas. Therap. Adv. Gastroenterol. 2017. Vol. 10, № 8. P. 599–607. https://doi.org/10.1177/1756283X17718408.Bor R., Fabian A., Balint A. et al. Endoscopic management of complications of self-expandable metal stents for treatment of malignant esophageal stenosis and tracheoesophageal fistulas. TheraP.Adv. Gastroenterol. 2017;10(8):599–607. https://doi.org/10.1177/1756283X17718408.Yang J., Siddiqui A. A., Kowalski T. E. et al. Esophageal stent fixation with endoscopic suturing device improves clinical outcomes and reduces complications in patients with locally advanced esophageal cancer prior to neoadjuvant therapy: a large multicenter experience. Surg. Endosc. 2017. Vol. 31. P. 1414–1419. https://doi.org/10.1007/s00464-016-5131-3.Yang J., Siddiqui A. A., Kowalski T. E. et al. Esophageal stent fixation with endoscopic suturing device improves clinical outcomes and reduces complications in patients with locally advanced esophageal cancer prior to neoadjuvant therapy: a large multicenter experience. Surg. Endosc. 2017;31:1414–1419. https://doi.org/10.1007/s00464-016-5131-3.Na H. K., Song H. Y., Kim J. H. et al. How to design the optimal selfexpandable oesophageal metallic stents: 22 years of experience in 645 patients with malignant strictures. Eur. Radiol. 2013. Vol. 23. P. 786–796. https://doi.org/10.1007/s00330-012-2661-5.Na H. K., Song H. Y., Kim J. H. et al. How to design the optimal selfexpandable oesophageal metallic stents: 22 years of experience in 645 patients with malignant strictures. Eur. Radiol. 2013;23:786–796. https://doi.org/10.1007/s00330-012-2661-5.Seven G., Irani S., Ross A. S. et al. Partially versus fully covered selfexpanding metal stents for benign and malignant esophageal conditions: a single center experience. Surg. Endosc. 2013. Vol. 27. P. 2185–2192. https://doi.org/10.1007/s00464-012-2738-x.Seven G., Irani S., Ross A. S. et al. Partially versus fully covered selfexpanding metal stents for benign and malignant esophageal conditions: a single center experience. Surg. Endosc. 2013;27:2185–2192. https://doi.org/10.1007/s00464-012-2738-x.Van Boeckel P. G., Repici A., Vleggaar F. P. et al. A new metal stent with a controlled-release system for palliation of malignant dysphagia: a prospective, multicenter study. Gastrointest. Endosc. 2010. Vol. 71. P. 455–460. https://doi.org/10.1016/j.gie.2009.09.046.Van Boeckel P. G., Repici A., Vleggaar F. P. et al. A new metal stent with a controlled-release system for palliation of malignant dysphagia: a prospective, multicenter study. Gastrointest. Endosc. 2010;71:455–460. https://doi.org/10.1016/j.gie.2009.09.046.Choi S. J., Kim J. H., Choi J. W. et al. Fully covered, retrievable selfexpanding metal stents (Niti-S) in palliation of malignant dysphagia: long-term results of a prospective study. Scand. J. Gastroenterol. 2011. Vol. 46. P. 875–880. https://doi.org/10.3109/00365521.2011.571706.Choi S. J., Kim J. H., Choi J. W. et al. Fully covered, retrievable selfexpanding metal stents (Niti-S) in palliation of malignant dysphagia: long-term results of a prospective study. Scand. J. Gastroenterol. 2011;46:875–880. https://doi.org/10.3109/00365521.2011.571706.Reijm A. N., Didden P., Bruno M. J., Spaander M. C. Early pain detection and management after esophageal metal stent placement in incurable cancer patients: A prospective observational cohort study. Endosc. Int. Open. 2016. Vol. 4, N8. P. E890–E894. https://doi.org/10.1055/s-0042-111202.Reijm A. N., Didden P., Bruno M. J., Spaander M. C. Early pain detection and management after esophageal metal stent placement in incurable cancer patients: A prospective observational cohort study. Endosc. Int. Open. 2016;4(8):E890–E894. https://doi.org/10.1055/s-0042-111202.Uesato M., Akutsu Y., Murakami K., Muto Y. Comparison of efficacy of self-expandable metallic stent placement in the unresectable esophageal cancer patients. Hindawi Gastroenterol. Res. Pract. 2017. Vol. 7. P. 2560510. https://doi.org/10.1155/2017/2560510.Uesato M., Akutsu Y., Murakami K., Muto Y. Comparison of efficacy of self-expandable metallic stent placement in the unresectable esophageal cancer patients. Hindawi Gastroenterol. Res. Pract. 2017;7:2560510. https://doi.org/10.1155/2017/2560510.Ferreira F., Bastos P., Ribeiro A. et al. A compara tive study between fluoroscopic and endoscopic guidance in palliative esophageal stent placement. Dis. Esophagus. 2012. Vol. 25. P. 608–613. https://doi.org/10.1111/j.1442-2050.2011.01288.x.Ferreira F., Bastos P., Ribeiro A. et al. A compara tive study between fluoroscopic and endoscopic guidance in palliative esophageal stent placement. Dis. Esophagus. 2012;25:608–613. https://doi.org/10.1111/j.1442-2050.2011.01288.x.Qiu G., Tao Y., Du X. et al. The impact of prior ra diotherapy on fatal complications after self-expandable me tallic stents (SEMS) for malignant dysphagia due to esopha geal carcinoma. Dis. Esophagus. 2013. Vol. 26. P. 175–181. https://doi.org/10.1111/j.1442-2050.2012.01348.x.Qiu G., Tao Y., Du X. et al. The impact of prior ra diotherapy on fatal complications after self-expandable me tallic stents (SEMS) for malignant dysphagia due to esopha geal carcinoma. Dis. Esophagus. 2013;26:175–181. https://doi.org/10.1111/j.1442-2050.2012.01348.x

The authors declare that there are no conflicts of interest present.