Self-Expandable Metal Stents in the Management of Cervical Oesophageal and/or Hypopharyngeal Strictures

Profili, Stefano; Meloni, Giovanni Battista; Feo, Claudio F.; Pischedda, A.; Bozzo, Corrado; Ginesu, Giorgio Carlo; Canalis, G.C.

doi:10.1053/crad.2002.0988

Cited by 41 publications

(35 citation statements)

References 11 publications

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“…Therefore, permanent uncovered metal stent dilation is not suitable for cases of functional stricture of the UGIT. Permanent partially covered metal stent dilation had poor mid-term and long-term therapeutic efficiency, mainly due to reflux and stent migration [27][28][29][30][31][32][33][34][35][36][37] . Temporary partially-covered metal stent dilation was used for benign stricture of the UGIT with both excellent immediate and mid-and long-term therapeutic efficacy.…”

Section: Discussionmentioning

confidence: 99%

Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion

Cheng¹,

Li²,

Chen³

et al. 2003

WJG

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AIM:To determine the best mothod for benign stricture of the upper gastrointestinal tract (UGIT) with stent insertion by follow-up evaluation. METHODS:A total of 110 stents insertions were performed in 110 cases of benign stricture of the UGIT. Permanent (group A) and temporary (group B) placement of an expandable metal stent in 30 cases and 80 cases respectively. All cases were completed under fluoroscopy. RESULTS:In group A, 30 uncovered or antireflux covered or partially covered expandable metal stents were placed permanently. In group A, 5 cases (16.7 %) in 3-months, 5 cases (20.0 %) in 6-months, 6 cases (25 %) in the 1 st year, 6 cases (50 %) in the 3 rd year, and 4 cases (80 %) in the 5 th year exhibited dysphagia relapse. In group B, a partiallycovered expandable metal stent was temporarily placed in each patient and removed after 3-7 days via gastroscopy. Follow-up data in this group showed that 8 cases (7.5 %) in 3-months, 9 cases (12.0 %) in 6-months,10 cases (15. CONCLUSION:The best mothod for benign stricture of UGIT with stent insertion is temporary placement of a partially-covered expandable metal stent.Cheng YS, Li MH, Chen WX, Zhuang QX, Chen NW, Shang KZ. Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion.

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Section: Discussionmentioning

confidence: 99%

Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion

Cheng¹,

Li²,

Chen³

et al. 2003

WJG

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“…In fact, the placement of a stent in the cervical esophagus has traditionally been restricted because of the risk of potential adverse events such as tracheal compression, proximal migration, intractable pain and, most commonly, foreign body sensation (10,11). Nevertheless, some reports have suggested the possibility of treating this type of stricture by placing a stent in the cervical esophagus (12). Optimal management is unclear due to the fact that findings in the literature are heterogeneous and include both malignant and benign strictures, and the recommendation for radiological or endoscopic approaches differ between studies.…”

Section: Introductionmentioning

confidence: 99%

Endoscopically placed stents: a useful alternative for the management of refractory benign cervical esophageal stenosis

et al. 2017

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Introduction: Benign esophageal strictures are relatively frequent and can severely affect the quality of life of a patient. Stenting has been proposed for the treatment of refractory cases. Lesions affecting the cervical esophagus are more difficult to treat, and the placement of stents in this location has traditionally been restricted due to potential adverse events. The aim of this study was to describe the efficacy and safety of endoscopic stenting in the management of refractory benign cervical esophageal strictures (RBCES) in a single-center cohort study. Methods:We analyzed 12 patients with RBCES (Kochman's criteria) and severe dysphagia. We recorded previous endoscopic treatments, stricture characteristics and demographic data. The two types of stents used were fully covered self-expandable metallic stents (FCSEMS) and uncovered biodegradable stents (BDS). FCSEMS were removed eight weeks after placement, and BDS were followed-up until degradation. We assessed technical and clinical success, rate of stricture recurrence and adverse events.Results: The mean age of participants was 64 years (range 30-85). A total of 23 stents (13 FCSEMS and 10 BDS) were placed in 12 patients (median 1.92, range 1-4). The technical success rate was 96% (22/23 stents). Eight patients (66.6%) maintained adequate oral intake at the end of follow-up (median 33.3 months, range 3-84 months). Migration was recorded in 7/23 stents (30.4%) and epithelial hyperplasia in 4/23 stents (17.4%). No severe adverse events were noted. All patients complained of minor cervical pain after placement that was well controlled with mild analgesia.Conclusions: Endoscopic stent therapy seems to be effective and safe in the management of RBCES.

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“…Given the mobility of cricopharyngeus and the estimated size of the vertebral bodies in relation to the length of the upper oesophageal sphincter, previous studies have considered that stents placed with the proximal margin above the superior endplate of T2 carry a possibility of causing FBS. 3,4 There have been reports of successful stenting in the cervical esophagus, and even across cricopharyngeus, for a variety of pathologies including carcinomas, tracheo-oesophageal fistulas [4][5][6][7] and recurrence following subtotal oesophagectomy. 8 The purpose of this case series is to review our own experience of placing SEMS with the upper margins in the cervical esophagus.…”

Section: Introductionmentioning

confidence: 99%

“…It is also possible to obtain proximal release stents the use of which have been reported in the cervical esophagus. 7,8 These carry the benefit of accurately placing the vital, proximal margin, allowing any stent shortening to occur distally.…”

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confidence: 99%

The use of self-expanding metal stents in the cervical esophagus

Thrower

Nasrullah

Lowe

et al. 2016

Int J Gastrointest Interv

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A B S T R A C TA case series was conducted at our institution on the the use of self-expanding metal stents (SEMS) in the cervical esophagus and their tolerability. Departmental records identified 20 consecutive stents placed in the cervical esophagus of 12 patients at our institution. There were 6 men and 6 women, mean age 67.2 years (range, 47.6-91.6 years). Ten patients had either primary or recurrent malignant disease and two had benign disease; a recalcitrant stricture at the oesophago-gastric anastomosis following oesophagectomy and a tracheo-oesophageal fistula secondary to tracheomalacia. Three patients received multiple stents on separate occasions requiring 2, 3, and 6 stents. Nineteen stents were placed radiologically with fluoroscopic guidance via a per-oral route under conscious sedation, and one was placed under direct endoscopic visualisation. Patients were followed up until death or to date. All stents were successfully deployed across the strictures. There was no foreign body sensation (FBS) reported after 16 of the procedures (80%). One patient reported transient FBS. Three stents were removed without complication because of symptoms; the endoscopically placed stent which was within 5 mm of cricopharyngeus and two which were inadvertently deployed across cricopharyngeus. There were no other significant complications related to the stent or procedure. All patients reported significant improvement in dysphagia with dysphagia scores improving from a mean of 3.1/4 to 0.9/4 (Wilcoxon matched-pairs signed-ranks test, P = 0.0158). One stent migrated in a patient with malignant disease; however, all 6 stents placed across the benign stricture migrated. Hence our case series concludes that SEMS can be safely and effectively deployed in the cervical esophagus.

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Self-Expandable Metal Stents in the Management of Cervical Oesophageal and/or Hypopharyngeal Strictures

Cited by 41 publications

References 11 publications

Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion

Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion

Endoscopically placed stents: a useful alternative for the management of refractory benign cervical esophageal stenosis

The use of self-expanding metal stents in the cervical esophagus

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