Self-expandable metal stents in esophageal cancer before preoperative neoadjuvant therapy: efficacy, safety, and long-term outcomes

Rodrigues‐Pinto, Eduardo; Ferreira‐Silva, Joel; Sousa‐Pinto, Bernardo; Medas, Renato; Garrido, Isabel; Siersema, Peter D.; Pereira, Pedro; Macedo, Guilherme

doi:10.1007/s00464-020-08002-8

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…In the past, SEMS placement before surgery has been reported to be associated with a worse oncologic outcome with a lower rate of R0 resections, a higher rate of major adverse events, and decreased overall survival [59,60]. Contrarily, recent studies have reported no difference in R0 resection rate, overall survival, and postoperative complications [61][62][63].…”

Section: Bridge To Surgerymentioning

confidence: 99%

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

et al. 2021

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Main recommendations Malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliation of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass.Strong recommendation, high quality evidence. 2 ESGE recommends brachytherapy as a valid alternative, alone or in addition to stenting, in esophageal cancer patients with malignant dysphagia and expected longer life expectancy.Strong recommendation, high quality evidence. 3 ESGE recommends esophageal SEMS placement for sealing malignant tracheoesophageal or bronchoesophageal fistulas. Strong recommendation, low quality evidence. 4 ESGE does not recommend SEMS placement as a bridge to surgery or before preoperative chemoradiotherapy because it is associated with a high incidence of adverse events. Other options such as feeding tube placement are preferable. Strong recommendation, low quality evidence. Benign disease 5 ESGE recommends against the use of SEMSs as first-line therapy for the management of benign esophageal strictures because of the potential for adverse events, the availability of alternative therapies, and their cost. Strong recommendation, low quality evidence. 6 ESGE suggests consideration of temporary placement of self-expandable stents for refractory benign esophageal strictures. Weak recommendation, moderate quality evidence. 7 ESGE suggests that fully covered SEMSs be preferred over partially covered SEMSs for the treatment of refractory benign esophageal strictures because of their very low risk of embedment and ease of removability. Weak recommendation, low quality evidence. 8 ESGE recommends the stent-in-stent technique to remove partially covered SEMSs that are embedded in the esophageal wall. Strong recommendation, low quality evidence. 9 ESGE recommends that temporary stent placement can be considered for the treatment of leaks, fistulas, and perforations. No specific type of stent can be recommended, and the duration of stenting should be individualized. Strong recommendation, low quality of evidence. 10 ESGE recommends considering placement of a fully covered large-diameter SEMS for the treatment of esophageal variceal bleeding refractory to medical, endoscopic, and/or radiological therapy, or as initial therapy for patients with massive bleeding. Strong recommendation, moderate quality evidence.

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Section: Bridge To Surgerymentioning

confidence: 99%

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

et al. 2021

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“…Bridge-To-Surgery Patients In the curative setting, as bridge to surgery, SEMS placement is not recommended by most recent guidelines, since it may be associated with worse oncologic outcomes, a lower rate of R0 resection, increased 3-year follow-up recurrence, lower overall survival, and a higher rate of major AEs [26,27]. Although some recent studies reported no differences in R0 resection rate and overall survival, SEMS placement may increase postoperative morbidity and mean operative time making surgery more challenging [28][29][30]. Nevertheless, esophageal stents are helpful to ameliorate nutritional status during or before neoadjuvant therapy and/or surgery [31].…”

Section: Malignant Esophageal Cancer Palliation Of Malignant Dysphagiamentioning

confidence: 99%

Best Practices in Esophageal, Gastroduodenal, and Colonic Stenting

Medas

Ferreira‐Silva

Girotra

et al. 2022

GE Port J Gastroenterol

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Endoscopic stenting is an area of endoscopy that has witnessed noteworthy advancements over the last decade, resulting in evolving clinical practices among gastroenterologists around the world. Indications for endoscopic stenting have progressively expanded, becoming a frequent part of the management algorithm for various benign and malignant conditions of the gastrointestinal tract, from esophagus to rectum. In addition to expanded indications, continuous technological enhancements and development of novel endoscopic stents have resulted in an increased success of these approaches and, in some cases, allowed new applications. This review aimed to summarize best practices in esophageal, gastroduodenal, and colonic stenting.

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“…32,33 While some recent studies have not supported this, we think ES placement should be avoided if surgical resection is planned in lieu of other alternatives, such as nasogastric tube or percutaneous feeding tube. [32][33][34][35][36] If patients are symptomatic, unable to maintain hydration and/or nutrition, and have a life expectancy less than 3 months, we favor the upfront placement of an ES. ES offers rapid improvement of symptoms but is associated with AEs including stent migration, which may increase the burden of endoscopic procedures that patients must undergo.…”

Section: Selection Of Therapymentioning

confidence: 99%

Section: Therapeutic Interventionsmentioning

confidence: 99%

Palliation of Malignant Dysphagia: Dilation, Stents, Cryoablation or PDT: The GI Perspective

Ellis

Kubiliun

Tavakkoli

2022

Foregut: The Journal of the American Foregut Society

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Self-expandable metal stents in esophageal cancer before preoperative neoadjuvant therapy: efficacy, safety, and long-term outcomes

Cited by 7 publications

References 25 publications

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

Best Practices in Esophageal, Gastroduodenal, and Colonic Stenting

Palliation of Malignant Dysphagia: Dilation, Stents, Cryoablation or PDT: The GI Perspective

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