A comparison of the temporary placement of 3 different self-expanding stents for the treatment of refractory benign esophageal strictures: a prospective multicentre study

BMC Gastroenterology

Maria Filipa Costa Neves Santos-Silva⁴  Beatriz Alda Henriques Costa Neves⁵  António Vasco Mello Pereira Coutinho³  Carlos Manuel Menezes Romão⁵  Pedro Miguel Pinto-Marques²  Ricardo António Natário Rio-Tinto¹  Manuel José Antunes Liberato³  Jorge Manuel Tavares Canena³ 

[1] Department of Gastroenterology, Santo António dos Capuchos Hospital, Alameda Santo António dos Capuchos, 1169-050, Lisbon, Portugal;Department of Gastroenterology, Garcia de Orta Hospital, Avenida Torrado da Silva, Pragal, 2801-951, Almada, Portugal;Center of Gastroenterology, Cuf Infanto Santo Hospital, Travessa do Castro n° 3, 1350-070, Lisbon, Portugal;Catolica Lisbon School of Business & Economics, Palma de Cima, 1649-023, Lisbon, Portugal;Department of Gastroenterology, Pulido Valente Hospital, Faculty of Medical Sciences, Alameda das Linhas de Torres n° 117, 1769-001, Lisbon, Portugal

关键词: Expandable esophageal stents;    Self-expanding plastic stents;    Biodegradable stents;    Fully covered self-expanding metal stents;    Refractory benign esophageal strictures;   

Others  :  1113037
DOI  :  10.1186/1471-230X-12-70

 received in 2012-01-27, accepted in 2012-05-24,  发布年份 2012

【 摘 要 】

Background

Refractory benign esophageal strictures (RBESs) have been treated with the temporary placement of different self-expanding stents with conflicting results. We compared the clinical effectiveness of 3 types of stents: self-expanding plastic stents (SEPSs), biodegradable stents, and fully covered self-expanding metal stents (FCSEMSs), for the treatment of RBES.

Methods

This study prospectively evaluated 3 groups of 30 consecutive patients with RBESs who underwent temporary placement of either SEPSs (12 weeks, n = 10), biodegradable stents (n = 10) or FCSEMSs (12 weeks, n = 10). Data were collected to analyze the technical success and clinical outcome of the stents as evaluated by recurrent dysphagia, complications and reinterventions.

Results

Stent implantation was technically successful in all patients. Migration occurred in 11 patients: 6 (60%) in the SEPS group, 2 (20%) in the biodegradable group and 3 (30%) in the FCSEMS group (P = 0.16). A total of 8/30 patients (26.6%) were dysphagia-free after the end of follow-up: 1 (10%) in the SEPS group, 3 (30%) in the biodegradable group and 4 (40%) in the FCSEMS group (P = 0.27). More reinterventions were required in the SEPS group (n = 24) than in the biodegradable group (n = 13) or the FCSEMS group (n = 13) (P = 0.24). Multivariate analysis showed that stricture length was significantly associated with higher recurrence rates after temporary stent placement (HR = 1.37; 95% CI = 1.08-1.75; P = 0.011).

Conclusions

Temporary placement of a biodegradable stent or of a FCSEMS in patients with RBES may lead to long-term relief of dysphagia in 30 and 40% of patients, respectively. The use of SEPSs seems least preferable, as they are associated with frequent stent migration, more reinterventions and few cases of long-term improvement. Additionally, longer strictures were associated with a higher risk of recurrence.

【 授权许可】

   
2012 Canena et al.; licensee BioMed Central Ltd.

【 图 表 】

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