A comparison of the temporary placement of 3 different self-expanding stents for the treatment of refractory benign esophageal strictures: a prospective multicentre study
نویسندگان
چکیده
BACKGROUND Refractory benign esophageal strictures (RBESs) have been treated with the temporary placement of different self-expanding stents with conflicting results. We compared the clinical effectiveness of 3 types of stents: self-expanding plastic stents (SEPSs), biodegradable stents, and fully covered self-expanding metal stents (FCSEMSs), for the treatment of RBES. METHODS This study prospectively evaluated 3 groups of 30 consecutive patients with RBESs who underwent temporary placement of either SEPSs (12 weeks, n = 10), biodegradable stents (n = 10) or FCSEMSs (12 weeks, n = 10). Data were collected to analyze the technical success and clinical outcome of the stents as evaluated by recurrent dysphagia, complications and reinterventions. RESULTS Stent implantation was technically successful in all patients. Migration occurred in 11 patients: 6 (60%) in the SEPS group, 2 (20%) in the biodegradable group and 3 (30%) in the FCSEMS group (P = 0.16). A total of 8/30 patients (26.6%) were dysphagia-free after the end of follow-up: 1 (10%) in the SEPS group, 3 (30%) in the biodegradable group and 4 (40%) in the FCSEMS group (P = 0.27). More reinterventions were required in the SEPS group (n = 24) than in the biodegradable group (n = 13) or the FCSEMS group (n = 13) (P = 0.24). Multivariate analysis showed that stricture length was significantly associated with higher recurrence rates after temporary stent placement (HR = 1.37; 95% CI = 1.08-1.75; P = 0.011). CONCLUSIONS Temporary placement of a biodegradable stent or of a FCSEMS in patients with RBES may lead to long-term relief of dysphagia in 30 and 40% of patients, respectively. The use of SEPSs seems least preferable, as they are associated with frequent stent migration, more reinterventions and few cases of long-term improvement. Additionally, longer strictures were associated with a higher risk of recurrence.
منابع مشابه
Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures
Endoscopic stent placement is a well-accepted and effective alternative treatment modality for complex and refractory esophageal strictures. Among the currently available types of stents, the partially covered self-expanding metal stent (SEMS) has a firm anchoring effect, preventing stent migration and ensuring effective covering of a narrowed segment. However, hyperplastic tissue reaction driv...
متن کاملProspective pilot study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures: long-term outcomes
Endoscopic placement of a single plastic stent (PS) to the main pancreatic duct (MPD) is awidely accepted treatment method for symptomatic strictures in patients with chronic pancreatitis [1,2]. Although adequate stent placement in the dominant stricture will relieve pain in the majority of patients [3–5], stents cannot be definitively removed in approximately one-third of patients because of p...
متن کاملSubclavian artery-esophageal fistula after placement of a self-expanding metal stent in a patient with esophagogastric anastomosis stenosis
Background: There have been reports on stent-related vascular erosions about patients with benign or malignant stenosis of the esophagus who received endoscopic stent insertion for palliative intention for oral intake. Case presentation: A 61-year-old woman with esophageal cancer located in the middle part of esophagus was treated with esophagectomy. Two years following the surgery, malignan...
متن کاملBiodegradable esophageal stents in benign and malignant strictures – a single center experience
BACKGROUND AND STUDY AIMS Biodegradable (BD) esophageal stents were recently developed mainly for refractory benign strictures, but experience and available literature are limited. PATIENTS AND METHODS This was a retrospective observational study. All patients who had BD stents inserted due to refractory benign esophageal strictures or malignant strictures, or were awaiting radical radiothera...
متن کاملEsophageal stents for benign refractory strictures: a meta-analysis.
BACKGROUND AND AIMS Fully covered self-expanding removable stents (SERS) have been considered a viable alternative to serial bougienage. The primary aim of this meta-analysis was to determine the efficacy of SERS for refractory esophageal strictures. METHODS Medline, Embase, and PubMed databases were searched using the keywords "esophageal stricture," "esophageal stents," "benign stricture," ...
متن کامل