Gastrointestinal Stent Update

Kang, Shin‐Geol

doi:10.5009/gnl.2010.4.s1.s19

Cited by 11 publications

(11 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[2][3][4][5][6][7][8][9][14][15][16][17][18] In the 1990s, endoscopic stents were introduced initially for palliation of malign esophageal stenosis. 19,20 First reports on the use of these stents for esophageal leaks followed soon. 12,13,19,20 Furthermore, endoscopic stenting became a widely accepted treatment alternative for anastomotic leaks after esophagectomy.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Stent Insertion versus Primary Operative Management for Spontaneous Rupture of the Esophagus (Boerhaave Syndrome): An International Study Comparing the Outcome

Schweigert

Beattie

Solymosi

et al. 2013

The American Surgeon

View full text Add to dashboard Cite

Spontaneous rupture of the esophagus (Boerhaave syndrome) is an extremely rare, life-threatening condition. Traditionally surgery was the treatment of choice. Endoscopic stent insertion offers a promising alternative. The aim of this study was to compare the results of primary surgical therapy with endoscopic stenting. A British and a German high-volume center for esophageal surgery participated in this retrospective study. At the British center, operative therapy (primary repair or surgical drainage) was routinely carried out. Endoscopic stent insertion was the primary treatment option at the German center. Only patients with nonmalignant, spontaneous rupture of the esophagus (Boerhaave syndrome) were included. Demographic characteristics, comorbidity, clinical course, and outcome were analyzed. The study comprises 38 patients with a median age of 60 years. Time between rupture and treatment was less than 24 hours in 22 patients. Overall mortality was four of 38. Diagnosis greater than 24 hours was associated with higher risk for fatal outcome (odds ratio [OR], 4.64; 95% confidence interval [CI], 0.33 to 265.79). The surgery (S) and the endoscopic stent group (E) included 20 and 13 cases, respectively. Esophagectomy was unavoidable in three cases and two were managed conservatively. There were no significant differences in age, time to diagnosis less than 24 hours, intensive care unit days, hospital stay, sepsis, renal failure, slow respiratory weaning, or presence of comorbidity between the two groups. In 11 of 13 in the stent group, operative intervention (video-assisted thoracic surgery, thoracotomy, mediastinotomy) was eventually mandatory and three of 13 even required repeated surgery. The rate of reoperation in the surgery group was six of 20. Mortality was two of 13 (E) versus one of 20 (S). The odds for fatal outcome were 3.3 times higher in the stent group than in the surgery group (OR, 3.32; 95% CI, 0.15 to 213.98). Management of Boerhaave syndrome by means of endoscopic stent insertion offers no advantage regarding morbidity, intensive care unit or hospital stay, and is associated with frequent treatment failure eventually requiring surgical intervention. Furthermore, endoscopic stenting shows a higher risk for fatal outcome than primary surgical therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic Stent Insertion versus Primary Operative Management for Spontaneous Rupture of the Esophagus (Boerhaave Syndrome): An International Study Comparing the Outcome

Schweigert

Beattie

Solymosi

et al. 2013

The American Surgeon

View full text Add to dashboard Cite

show abstract

“…The Gianturco Z-stent was the first commercially available stent and was mainly use for palliation of esophageal stenosis. 34 Endoscopic stent insertion for esophageal leakage and perforations followed soon. The introduction of Nitinol wire, a nickel-titanium alloy, for selfexpandable metallic stents was another milestone in the development of endoscopic stents.…”

Section: Closure Of Spontaneous Esophageal Rupture By Means Of Endoscopic Stent Insertion (1990s)mentioning

confidence: 99%

Times and Trends in the Treatment of Spontaneous Perforation of the Esophagus: From Herman Boerhaave to the Present Age

Schweigert

Dubecz

Solymosi

et al. 2013

The American Surgeon

View full text Add to dashboard Cite

Spontaneous rupture of the esophagus is a rare devastating condition, which was first described by Herman Boerhaave in 1724. Only a handful of cases were recorded during the 18th and 19th centuries. Diagnosis was usually obtained on autopsy. Only in 1914 Irving Walker achieved the first antemortem diagnosis of spontaneous rupture of the esophagus. The dawn of thoracic surgery during the first decades of the 20th century opened up the way for operative cure. More than 200 years after Boerhaave's initial report, Barrett as well as Clagett and Olsen independently accomplished the first successful surgical treatment by primary repair of the esophageal lesion in 1947. Since those pioneer days, various suggestions for proper treatment have been made ranging from conservative, nonoperative means to extended procedures such as esophagectomy. Invention of minimally invasive surgery and endoscopic measures has further broadened the spectrum of available therapeutic options. The aim of this history article is to outline the development of diagnosis and management of spontaneous rupture of the esophagus from the age of Herman Boerhaave to the present times.

show abstract

“… 3 Therefore, SEMS were fully covered with a silicone membrane to reduce ingrowth of granulation tissue. 4 Unfortunately, covered stents are more apt to migrate, are less flexible, and have a shorter radial force. These problems prompted the development of partially covered metal stents with flared uncovered segments at both ends 1 , 4 , 5 and self-expanding plastic stents (SEPS) to minimize hyperplastic tissue reactions.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Unfortunately, covered stents are more apt to migrate, are less flexible, and have a shorter radial force. These problems prompted the development of partially covered metal stents with flared uncovered segments at both ends 1 , 4 , 5 and self-expanding plastic stents (SEPS) to minimize hyperplastic tissue reactions. 6 The need for removal is an important disadvantage of SEPS and SEMS.…”

Section: Introductionmentioning

confidence: 99%

Self-Expanding Biodegradable Stents for Postoperative Upper Gastrointestinal Issues

Köneş

Oran

2018

JSLS

View full text Add to dashboard Cite

Background and Objectives:Endoscopic stenting is a minimally invasive treatment modality for patients with various gastrointestinal conditions. We evaluated the safety and efficacy of uncovered biodegradable stents for postoperative leaks and strictures in the upper gastrointestinal tract.Methods:This was a retrospective study of patients treated endoscopically with biodegradable stents from January 2010 through November 2017.Results:Thirteen patients were enrolled, 7 of whom were men. Their mean age was 46 (range, 21–82) years. The indications for stent placement were postoperative leakage and stricture in 9 and 4 patients, respectively. The primary diagnoses were obesity in 7 patients, gastric cancer in 5, and peptic ulcer in 1. The average time to stent placement after surgery was 35 (range, 17–125) and 166 (range, 153–185) days for patients with postoperative leakage and stricture, respectively. Stent insertion was successful at the first attempt in all patients. Complete resolution of the leak and stricture was achieved after stent application in 11 patients, for a clinical success rate of 85%. The mean follow-up duration was 50 (range, 24–76) months. There were no major complications.Conclusions:Compared to self-expanding metal and plastic stents, the main advantages of uncovered biodegradable stents are that they do not have to be removed and have a low migration rate. Our results suggest that these stents have promise for management of postoperative gastrointestinal complications. Further randomized trials with larger sample sizes are necessary to determine the role of biodegradable stents in the treatment algorithm.

show abstract

Gastrointestinal Stent Update

Cited by 11 publications

References 32 publications

Endoscopic Stent Insertion versus Primary Operative Management for Spontaneous Rupture of the Esophagus (Boerhaave Syndrome): An International Study Comparing the Outcome

Endoscopic Stent Insertion versus Primary Operative Management for Spontaneous Rupture of the Esophagus (Boerhaave Syndrome): An International Study Comparing the Outcome

Times and Trends in the Treatment of Spontaneous Perforation of the Esophagus: From Herman Boerhaave to the Present Age

Self-Expanding Biodegradable Stents for Postoperative Upper Gastrointestinal Issues

Contact Info

Product

Resources

About