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

Jorge Canena, Manuel José A Liberato, Ricardo António N Rio-Tinto, Pedro M. Pinto-Marques, Carlos Romão, António Vasco Mello Pereira Coutinho, Beatriz Neves, Maria Filipa Costa Neves Santos-Silva

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Abstract

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.

Original languageEnglish
Article number70
Pages (from-to)Online
Number of pages13
JournalBMC Gastroenterology
Volume12
DOIs
Publication statusPublished - 12 Jun 2012

Keywords

  • Biodegradable stents
  • Expandable esophageal stents
  • Fully covered self-expanding metal stents
  • Refractory benign esophageal strictures
  • Self-expanding plastic stents

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    Canena, J., Liberato, M. J. A., Rio-Tinto, R. A. N., Pinto-Marques, P. M., Romão, C., Coutinho, A. V. M. P., ... Santos-Silva, M. F. C. N. (2012). 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, 12, Online. [70]. https://doi.org/10.1186/1471-230X-12-70