Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis

Law, Ryan; Prabhu, Anoop; Fujii-Lau, Larissa L.; Shannon, Carol; Singh, Siddharth

doi:10.1007/s00464-017-5720-9

Cited by 88 publications

(52 citation statements)

References 25 publications

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“…Another promising method of anchoring is endoscopic suturing with the novel, FDA-approved, endoscopic suturing device [ 78 ]. A systematic review and meta-analysis was performed to analyze retrospective case series ( n = 14), investigating endoscopic suture fixation of esophageal covered SEMS [ 79 •]. Results from some case series look promising, but pooled data analysis revealed that stent migration occurred in still 1 of 6 patients after suture fixation.…”

Section: Utilization and Limitations Of Esophageal Stentsmentioning

confidence: 99%

Esophageal Stenting in Clinical Practice: an Overview

Vermeulen

Siersema

2018

Curr Treat Options Gastro

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Opinion statementPurpose of reviewEsophageal stents are used in clinical practice for endoscopic treatment of a wide variety of esophageal diseases and conditions. This review provides key principles and a literature update on the utility and limitations of esophageal stenting in clinical practice.Recent findingsIndications for esophageal stenting can be subdivided into two groups. The first group consists of patients with malignant or benign dysphagia, in which an esophageal stent restores luminal patency. In the past years, temporary stent placement has increasingly been used in the therapeutic management of refractory benign esophageal strictures. When endoscopic repeated bougie dilation and other endoscopic treatment modalities have failed, an esophageal stent could be considered. Based on the literature, a fully covered self-expandable metal stent may be the preferred choice for the treatment of both malignant and benign dysphagia. The second group consists of patients with leakage from the esophageal lumen into the surrounding tissue. Esophageal leakage can be subdivided into three forms, benign esophageal perforations (iatrogenic and spontaneous), anastomotic leakage after reconstructive esophageal surgery, and fistula. In a carefully selected group of patients, a covered esophageal stent may be used for sealing off the leakage, thereby preventing further contamination of the tissue surrounding the defect. The past few years, several validated prediction tools have been developed that may assist clinicians in the selection of patients eligible for esophageal stent placement. Based on retrospective studies and expert opinion, a partially or fully covered self-expandable metal stent may have a role in treatment of esophageal leakage.SummaryResearch do date supports the utilization of esophageal stents for the treatment of malignant or benign dysphagia and esophageal leakage.

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Section: Utilization and Limitations Of Esophageal Stentsmentioning

confidence: 99%

Esophageal Stenting in Clinical Practice: an Overview

Vermeulen

Siersema

2018

Curr Treat Options Gastro

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“…Assembling studies from 2011 to 2016, Law et al conducted a systematic review and meta-analysis on use of stent suturing in the esophagus, totaling 14 studies and 212 patients. Pooled technical success rate of stent placement and fixation was high at 96.7% (I 2 = 0%) and migration rate was 15.9% (95% confidence interval 11.4-21.6%; I 2 = 0), markedly lower than reported values of esophageal stent migration rates without suturing in the literature [11].…”

Section: Suturingmentioning

confidence: 62%

“…Sutures that target the proximal flange of a stent are typically delivered through a repeated sequence of mucosa-stent-mucosa pattern, often in an interrupted fashion, with the goal of reaching the muscularis propria of esophageal tissue. Notably, sutures should be placed loosely to accommodate the ebb and flow of peristaltic contractions, lest over-tightened sutures result in increased tissue pressure and necrosis, prompting subsequent suture failure [11].…”

Section: Suturingmentioning

confidence: 99%

“…To further reduce the risk of TEF, it is our practice to avoid stent placement proximal to 30 cm from the incisors whenever possible. As discussed previously, if endoscopic suturing is used for stent fixation, ensuring that sutures are not cinched too tightly, such that the stent may accommodate small antegrade and retrograde motion from peristalsis, can also minimize the risk of pressure necrosis [11].…”

Section: Formation Of Tracheoesophageal Fistulamentioning

confidence: 99%

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Improving stent efficiency by understanding stent-related adverse events

Maselli

Storm

Matar

et al. 2020

Techniques and Innovations in Gastrointestinal Endoscopy

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“…2 Different anchoring methods have been described (clips, suturing devices, over-the-scope clips and Shim technique 2 ), because of high migration rates (4-36%). 3,4 However, not all cases are candidates, mostly in "difficult" cases where enteral feeding is needed. 5 We report the use of the nasojejunalstent technique (NJST) to prevent migration of FCSEMS in three difficult cases.…”

mentioning

confidence: 99%

Nasojejunal‐stent technique: A new system to prevent fully covered metal stent migration in the treatment of benign esophageal diseases

Mondragón

Cuellar

Pérez

2018

Digestive Endoscopy

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BRIEF EXPLANATIONF ULLY COVERED SELF-EXPANDABLE metal stents (FCSEMS) have been used for the treatment of benign esophageal conditions such as perforation, leaks, and strictures, 1 and high clinical success is reported. 2 Different anchoring methods have been described (clips, suturing devices, over-the-scope clips and Shim technique 2 ), because of high migration rates (4-36%). 3,4 However, not all cases are candidates, mostly in "difficult" cases where enteral feeding is needed. 5 We report the use of the nasojejunalstent technique (NJST) to prevent migration of FCSEMS in three difficult cases.An 83-year-old man presented to the specialties hospital with hematemesis and hypovolemic shock. After resuscitation, a Sengstaken-Blakemore tube was placed and when (a) (b) (c) (d) (e) (f) Figure 1 (a) Left-sided esophageal perforation at the gastroesophageal junction level with a length of 40 mm (Boerhaave syndrome). (b) Mediastinal view throughout the esophageal perforation. (c) Endoscopic closure could not be done; therefore, a fully covered self-expandable metal stent (FCSEMS) of 18 mm 9 153 mm was placed. (d) Nasojejunal-stent technique was applied in order to avoid stent migration (retroflexion view). (e) Frontal view throughout the FCSEMS. (f) Finally, grasping of both "lassos" is carried out with a conventional hemostatic clip.

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Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis

Cited by 88 publications

References 25 publications

Esophageal Stenting in Clinical Practice: an Overview

Esophageal Stenting in Clinical Practice: an Overview

Improving stent efficiency by understanding stent-related adverse events

Nasojejunal‐stent technique: A new system to prevent fully covered metal stent migration in the treatment of benign esophageal diseases

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