Success and complications associated with placement of fully covered removable self-expandable metal stents for benign esophageal diseases (with videos)

Eloubeidi, Mohamad A.; Talreja, Jayant P.; Lopes, Thaís Rosental Gabriel; Al-Awabdy, Basil S.; Shami, Vanessa M.; Kahaleh, Michel

doi:10.1016/j.gie.2010.11.014

Cited by 96 publications

(74 citation statements)

References 38 publications

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“…The same results were also obtained by Eloubeidi et al [18]. In our study, seven patients suffered recurrent stricture within 3 months after stent removal.…”

Section: Discussionsupporting

confidence: 92%

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Removable, Fully Covered, Self-expandable Metal Stents for the Treatment of Refractory Benign Esophagogastric Anastomotic Strictures

Liu

Cui

et al. 2011

Dysphagia

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The use of metal stents for malignant esophageal strictures for palliation is well accepted. However, utilization of metal stents for benign esophageal diseases has been controversial. Given the availability of removable, fully covered, self-expandable metal stents (RFCSEMSs), this study was undertaken to evaluate the effectiveness and safety of RFCSEMSs in patients with refractory benign esophagogastric anastomotic strictures. Twenty-four patients with RFCSEMSs were enrolled in this study. All patients had undergone endoscopic Savary-Gilliard bougie dilatation five times or more but there was no significant improvement in symptoms. For all 24 patients, the symptom of dysphagia was alleviated significantly while the stent was in place and for a short time after stent removal, and dysphagia scores decreased from 3-4 to 0-1. After 12 months of follow-up, 18 patients were free from dysphagia but the other 6 patients still suffered obvious dysphagia. RFCSEMSs are still not perfect and can induce some complications. The treatment failure rate of restenting was remarkably high after the first failure. Given that effective methods for treating refractory stricture have not been found, RFCSEMSs could be considered for treating refractory benign esophagogastric anastomotic stricture.

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“…The same results were also obtained by Eloubeidi et al [18]. In our study, seven patients suffered recurrent stricture within 3 months after stent removal.…”

Section: Discussionsupporting

confidence: 92%

“…The total clinical success rate of this method was 75%. Another study also confirmed the safety of this kind of stent, but only 21% of patients with refractory strictures had successful long-term outcomes without any need for reintervention [18].…”

Section: Discussionmentioning

confidence: 79%

Removable, Fully Covered, Self-expandable Metal Stents for the Treatment of Refractory Benign Esophagogastric Anastomotic Strictures

Liu

Cui

et al. 2011

Dysphagia

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“…However, recurrent symptoms after dilation within the first year frequently occurred. And surgery can provide definitive treatment but has been associated with considerable mortality and morbidity, including the development of new anastomotic strictures [9,15,19,24,25]. So, unsuccessful management of benign esophageal stricture by serial endoscopic dilatation or surgery and the management of these refractory strictures have been considered challenging [9,26,27].…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 14 articles met our inclusion criteria for the pooled analysis (Table 1). A total of seven studies reported results on BD stent placement [5][6][7][8][9][10][11], seven on SEMS placement for the treatment of benign esophageal disease [12][13][14][15][16][17][18].…”

Section: Literature Searchmentioning

confidence: 99%

Literature Analysis of the Treatment of Benign Esophageal Disease with Stent

et al. 2015

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To analyze the efficacy and safety of benign esophageal disease used biodegradable (BD) stent or metal stent. The English literatures of benign esophageal disease that were treated by biodegradable or metal stents implantation were retrieved and summarized. In all 323 benign esophageal disease, the most common etiologies were benign refractory stricture, surgical anastomotic stricture and esophageal fistula/leak/perforation, but the main characteristics between the two groups were not significantly different. One hundred fifty-four cases were completely healed by using BD stents or self-expandable metal stents (SEMS) (47.7 %). Clinical success was achieved in 47.7 % of all patients and there was no significant difference between BD stents (51 %) and SEMS (46.2 %) (P=0.472), while stent migration occurred more frequently with SEMS (33.9 %) than with BD stent (19.6 %) (P≤ 0.05), and tissue in-or overgrowth occurred more frequently with SEMS (22.2 %) than with BD stents (8.8 %) (P≤0.05). Furthermore, the time about degradation of BD stents in esophageal was longer than removal of SEMS from the esophagus (P≤0.05). Placement of BD stents or SEMS provides effective and safe relief for benign esophageal disease. Clinical success and mortality were not significantly different. BD stents offers an advantage of fewer complications. Although stent placement is a viable strategy in patients with benign esophageal disease, the ideal treatment strategy and further randomized trials with large number of patients are needed.

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“…The use of SEPS grew steadily until 2010 when a number of studies reported successful use of metal stents. [55][56][57][58] Since then, the use of SEPS declined not only due to high migration rate but other factors like need for pre-deployment assembly, stiffness of the stent and large size delivery system. 59 Bakken et al 55 was one of the first to report FCSEMS (AliMaxx-E; Alveolus, Charlotte, NC, USA) for benign esophageal leaks.…”

Section: Endoluminal Stentsmentioning

confidence: 99%

Endoscopic management of postoperative fistulas and leaks

Devaraj

Gavini

2017

Int J Gastrointest Interv

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Postoperative complications from gastrointestinal surgery can be associated with significant morbidity, and mortality especially if repeat surgery is needed to address these complications. There are wide array of endoscopic interventions and tools available for management of these complications using minimally invasive methods thus decreasing length of hospitalization, morbidity and leading to better patient outcomes. With the advent new tools like Overstitch device, Over the Scope Clip, fibrin glue, etc., these complications can be managed successfully with minimal morbidity. We provide an indepth discussion about available endoscopic options and their application in various scenarios in our article. Endoscopist should be familiar with these complications and endoscopic tools to promote use of these tools and techniques to achieve successful management of these complex conditions.

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Success and complications associated with placement of fully covered removable self-expandable metal stents for benign esophageal diseases (with videos)

Cited by 96 publications

References 38 publications

Removable, Fully Covered, Self-expandable Metal Stents for the Treatment of Refractory Benign Esophagogastric Anastomotic Strictures

Removable, Fully Covered, Self-expandable Metal Stents for the Treatment of Refractory Benign Esophagogastric Anastomotic Strictures

Literature Analysis of the Treatment of Benign Esophageal Disease with Stent

Endoscopic management of postoperative fistulas and leaks

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