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We investigated the palliative effect of self-expanding metallic stents on malignant obstruction of the esophagus in 10 patients. All patients had high grade dysphagia and one had an esophago-bronchial fistula. Endoscopic insertions of the prosthesis was done under sedation. Dilatation of the stricture prior to insertion was rarely necessary. Coated stents were used as secondary treatment for patients with fistulae. The procedure related morbidity was low and no mortality was observed. The stents remained patent during the residual lifetime of the patients. Dislocation or perforation did not occur. The median survival of 8 deceased patients was 3.5 months (range 1.25-14.5 months). At present 2 patients are still alive 2.7 and 1.5 months after the procedure. Self-expanding stents in the esophagus provide good palliative therapy of dysphagia or fistulae caused by malignant tumors. Insertion is relatively simple and safer than in nonexpandable types. These improvements may justify the considerably higher price of these devices.