Distributor (manufacturer) here can be your Logo A comparative Study Comparing A New Anti-reflux Stent To A conventional open stent in the palliation of distal oesophageal cancer Cynthia Kanagasundaram Jonathan Segal Anthony Leahy, Mark Fullard, Jeremy Livingstone Watford Hospital West Hertfordshire Hospitals NHS Trust Methods A prospective study involving 40 patients with cancer involving the gastro-oesophageal junction. All patients will have been previously deemed inoperable within the local multi-disciplinary team meeting. Patients will receive either an anti-reflux stent (cardia-valve stent, Premier endoscopy) or a conventional open stent (ultraflex, Boston Scientific). All stents will be partially covered and placed across the gastro-oesophageal junction. Outcomes Symptoms and quality of life will be measured using the European Organisation into Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the oesophageal module European Organisation into Research and Treatment of Cancer questionnaire (EORTC QLQ-OES18). The questionnaires will be recorded by the attending endoscopist/physician at weeks 0 and 1. Patients will be requested not to take proton pump inhibitors or H2 antagonists for the first week after stent insertion (antacids allowed during this period). Patients will be requested to finally complete the symptom questionnaires (via post/telephone) at month 3 Results There were 15 Ultraflex stents and 8 cardiovalve stents that were followed up. Baseline EORTC QLQ-OES18 showed no significant differences in baseline scores The overall ultravalve group improved their reflux score by 5 and the cardiovalve improved by 6 points. This was not significant p= 0.0831 Introduction Oesophageal cancer is the sixth most common cause of death from cancer in the United Kingdom,.(1) Oesophageal cancer has a 5 year survival rate of 10-15%.(2-3) More than half of patients have inoperable disease at presentation.(4) The goals of palliative therapy in patients with unresectable cancer are to ameliorate symptoms of dysphagia, treat complications, maintain oral intake, minimise hospital stay, relieve pain, eliminate reflux and regurgitation, prevent aspiration and ultimately improve their quality of life.(5) Various therapies have been used to palliate dysphagia and one of the main methods to achieve this is the insertion of an oesophageal stent. Oesophageal intubation with a self-expanding stent is the treatment of choice for stenosing tumours, where rapid relief of dysphagia in a one stage procedure is desirable.(6) complications after stent insertion occur in approximately 30-35%.Complications seem to be higher when the stent crosses the gastro-oesophageal junction.(5) There have been various stent designs marketed that incorporate an anti-reflux valve stent with a view to reducing this complication.. Please export the Keynote document as a PDF (File – Save as – PDF – Image Quality – Best) and upload the PDF into the system. Please use the font in the document or a similar one and do not use a font size smaller than 16. Table 1: Design characteristics of marketed anti-reflux stents Stent Distributor (manufacturer) Anti-reflux design Diameter Lengths Partial covering Z stent Dua   Cook Medical Windsock 18/25mm 8, 10, 12, 14cm Yes FerX-Ella UK Medical (Ella-CS) 20/36mm 9, 10.5, 12, 13.5, 15, 16.5 cm EGIS BVM 16/24, 18/26, 20/28mm 4, 6, 8, 10, 12cm Hanarostent EPV Diagmed UK (M.I. Tech) S shape valve 22/28mm 12cm Cardia-valve Premier endoscopy (Micro-Tech) 2 way oblique valve 20/26, 24/30mm 10, 12cm Aim To compare a new anti-reflux stent with a conventional open stent in the palliation of patients with distal oesophageal cancer Conclusion There were no significant differences in EORTC QLQ-OES18 scores between the two groups at week one There were no significant improvements in reflux scorebetween the two groups. There appeared to have similar quality of life profiles at week one post insertion. This is a small study and longer time follow up data is currently ongoing with 3 month follow up data of 40 patients currently being analysed Types of Stents Type of stents References Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer 1999; 83: 18-29 Cancer Research UK. www.info.cancerresearchuk.org. Sundelof M, Ye W, Dickman PW, Lagergren J. Improved survival in both histologic types of oesophageal cancer in Sweden. Int J Caner 2002; 99: 751-54 Sagar PM, Gauperaa T, Sue-Ling H. An audit of the treatment of cancer of the oesophagus, Gut 1994; 35: 943-45 Sharma P, Kozarek R. American College of Gastroenterology Practice Guideline: Role of esophageal stents in benign and malignant diseases. Am J Gastro 2010;105:258-73. Dua KS, Kozarek R, Kim J et al. Self-expanding metal esophageal stent with anti-reflux mechanism. Gastrointest Endosc 2001; 53: 603-13. Allum W, Blazeby J, GriffIn S. 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