Removal of esophageal expandable metal stents

Low, Donald E.; Kozarek, Richard A.

doi:10.1007/s00464-002-8528-0

Cited by 44 publications

(6 citation statements)

References 29 publications

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“…Leaving stents in place long term in patients whose life expectancy is not limited is considered to be inappropriate and potentially dangerous [9]. We have previously published a report documenting the feasibility of safe SEMS removal [12]. It is clear, however, that this process can be associated with significant risk.…”

Section: Discussionmentioning

confidence: 97%

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Polyflex self-expanding, removable plastic stents: assessment of treatment efficacy and safety in a variety of benign and malignant conditions of the esophagus

et al. 2007

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Section: Discussionmentioning

confidence: 97%

“…Removal of the SEMS has been described [12]. However, the difficulty and potential danger associated with their removal has significantly limited their application for benign patients apart from sporadic reports of their use in highly selected patients with esophageal perforation [13].…”

mentioning

confidence: 99%

Polyflex self-expanding, removable plastic stents: assessment of treatment efficacy and safety in a variety of benign and malignant conditions of the esophagus

et al. 2007

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“…Since the 1990s, esophageal intubation with stent prostheses has gradually developed. Several types of covered expandable metallic stents have been used with higher rates of complete closure of TEF, which can avoid certain complications, such as hemorrhage, perforation, pressure necrosis, food impaction, stent dislocation, occlusion, and migration [3], [11], [12], [13], [14], [15]. In Taiwan, feeding gastrostomy/jejunostomy and stenting have become the most common treatment modalities for TEF.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Esophageal Stent and Feeding Gastrostomy/Jejunostomy for Tracheoesophageal Fistula Caused by Esophageal Squamous Cell Carcinoma

Chen

Chiu

et al. 2012

PLoS ONE

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BackgroundA malignant tracheoesophageal/bronchoesophageal fistula (TEF) is a life-threatening complication of esophageal squamous cell carcinoma. A feeding gastrostomy/jejunostomy had been the most common treatment method for patients with TEF before the era of stenting. The aim of this retrospective study is to compare the prognosis of esophageal squamous cell carcinoma patients with TEF treated with an esophageal metallic stent to those treated with a feeding gastrostomy/jejunostomy.MethodsWe retrospectively reviewed a total of 1011 patients with esophageal squamous cell carcinoma between 1996 and 2011 at Kaohsiung Chang Gung Memorial Hospital, and 86 patients with TEF (8.5%) were identified. The overall survival and other clinical data were compared between 30 patients treated with an esophageal metallic stent and 35 patients treated with a feeding gastrostomy/jejunostomy.ResultsAmong the 65 patients receiving either an esophageal metallic stent or a feeding gastrostomy/jejunostomy, univariate analysis showed that treatment modality with an esophageal metallic stent (P = 0.007) and radiotherapy treatment after fistula diagnosis (P = 0.04) were predictive of superior overall survival. In the multivariate comparison, treatment modality with an esophageal metallic stent (P = 0.026, odds ratio: 1.859) represented the independent predictive factor of superior overall survival. There were no significant differences between groups in mean decrease in serum albumin or mean body weight loss. Compared to the feeding gastrostomy/jejunostomy group, a significantly higher proportion of patients in the stenting group (53% versus 14%, P = 0.001) were able to receive chemotherapy within 30 days after fistula diagnosis, indicating better infection control in the stenting group.ConclusionsCompared with a feeding gastrostomy/jejunostomy, an esophageal metallic stent significantly improves overall survival in patients with malignant TEF in our retrospective analysis. Esophageal metallic stent placement may be considered the first-line of treatment for patients with malignant TEF.

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“… 25 Although recent studies reported the usefulness of SEMSs for the treatment of benign esophageal stricture,26,27,28 potential late-onset complications are related to long-term stent placement. 26 , 27 , 28 , 29 , 30 Moreover, there is no removal mechanism in currently available SEMSs, which may result in difficult stent removal after long-term placement. Currently, no consensus on the appropriate duration of SEMS placement exists.…”

Section: Post-esd Stricture In the Esophagusmentioning

confidence: 99%

“…In previous studies, the duration of SEMS placement varied from 3 days to several months. 26 , 27 , 28 , 29 However, no report on SEMS placement for the treatment of post-ESD cicatricial stricture has existed until now. To overcome the difficulty in removing stents, the use of self-expanding Polyflex plastic stents (Willy Ruesch GMBH, Kernen, Germany), 25 fully covered retrievable SEMSs, 31 or biodegradable stents 32 , 33 has been suggested.…”

Section: Post-esd Stricture In the Esophagusmentioning

confidence: 99%

Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors

et al. 2014

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Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.

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Removal of esophageal expandable metal stents

Abstract: The safe removal of current brands of EMS may facilitate the wider application of these devices to include selective patients with benign disease.

Cited by 44 publications

References 29 publications

Polyflex self-expanding, removable plastic stents: assessment of treatment efficacy and safety in a variety of benign and malignant conditions of the esophagus

Polyflex self-expanding, removable plastic stents: assessment of treatment efficacy and safety in a variety of benign and malignant conditions of the esophagus

Comparative Study of Esophageal Stent and Feeding Gastrostomy/Jejunostomy for Tracheoesophageal Fistula Caused by Esophageal Squamous Cell Carcinoma

Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors

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