Safety and Efficacy of the Hilzo Esophageal Stent for the Management of Dysphagia in Malignant Esophageal Obstruction

Abstract A multi-institutional retrospective review in four oncology centers was performed during a 5-year period (2015–2020) identifying all patients who underwent placement of the Hilzo esophageal stent for the management of malignant esophageal obstruction. Patient notes, imaging, and reports of each procedure were reviewed for demographics, lesion, and tumor-specific characteristics. The primary outcome was an improvement in symptoms of dysphagia using the Mellow–Pinkas dysphagia score. Secondary outcomes were periprocedural mortality, 30-day mortality, tumor overgrowth/restenosis, stent migration, stent compression/failure-to-expand, worsening dysphagia of unidentified cause, and procedure-related complications. A total of 58 patients met the inclusion criteria for this study and were analyzed. The median follow-up was 151 days (range: 6–627). The median dysphagia score improved from 3 to 1. Improvement was noted on 90% of the cases reporting dysphagia data. The 30-day mortality rate was 16%. No major complications were noted related to the procedure (grade: 4–6). Minor complications (grade: 1–3) included chest pain/odynophagia/heartburn in 17 (29%) of patients which all settled with symptomatic management. Secondary outcomes were as follows: tumor overgrowth/restenosis, 13 (22%); stent migration, 9 (16%); stent compression/failure to expand, 3 (5%); and worsening dysphagia of unidentified cause, 4 (7%). The Hilzo stent performed in line with the performance of other esophageal stents on the market. Hilzo stent insertion improved dysphagia scores with no major complications reported.