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

Research Article

Maria Filipa Costa Neves Santos-Silva¹  Manuel José Antunes Liberato²  Pedro Miguel Pinto-Marques³  Beatriz Alda Henriques Costa Neves⁴  Carlos Manuel Menezes Romão⁴  António Vasco Mello Pereira Coutinho⁵  Jorge Manuel Tavares Canena⁵  Ricardo António Natário Rio-Tinto⁶ 

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

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

DOI  :  10.1186/1471-230X-12-70

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

来源: Springer

【 摘 要 】

BackgroundRefractory 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.MethodsThis 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.ResultsStent 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).ConclusionsTemporary 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】

CC BY   
© Canena et al.; licensee BioMed Central Ltd. 2012