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Logo of bmcgastBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Gastroenterology
 
BMC Gastroenterol. 2012; 12: 70.
Published online Jun 12, 2012. doi:  10.1186/1471-230X-12-70
PMCID: PMC3447662
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 Manuel Tavares Canena,corresponding author1,2 Manuel José Antunes Liberato,2 Ricardo António Natário Rio-Tinto,3 Pedro Miguel Pinto-Marques,4 Carlos Manuel Menezes Romão,1 António Vasco Mello Pereira Coutinho,1,2 Beatriz Alda Henriques Costa Neves,1 and Maria Filipa Costa Neves Santos-Silva5
1Department of Gastroenterology, Pulido Valente Hospital, Faculty of Medical Sciences, Alameda das Linhas de Torres n° 117, 1769-001, Lisbon, Portugal
2Center of Gastroenterology, Cuf Infanto Santo Hospital, Travessa do Castro n° 3, 1350-070, Lisbon, Portugal
3Department of Gastroenterology, Santo António dos Capuchos Hospital, Alameda Santo António dos Capuchos, 1169-050, Lisbon, Portugal
4Department of Gastroenterology, Garcia de Orta Hospital, Avenida Torrado da Silva, Pragal, 2801-951, Almada, Portugal
5Catolica Lisbon School of Business & Economics, Palma de Cima, 1649-023, Lisbon, Portugal
corresponding authorCorresponding author.
Jorge Manuel Tavares Canena: jmtcanena/at/live.com.pt; Manuel José Antunes Liberato: mjliberato/at/gmail.com; Ricardo António Natário Rio-Tinto: ricardo_rio_tinto/at/yahoo.com; Pedro Miguel Pinto-Marques: pmarques/at/hospitaldaluz.pt; Carlos Manuel Menezes Romão: menezes_romao/at/yahoo.com; António Vasco Mello Pereira Coutinho: avpc/at/ip.pt; Beatriz Alda Henriques Costa Neves: costaneves.beatriz/at/gmail.com; Maria Filipa Costa Neves Santos-Silva: filipa7santossilva/at/gmail.com
Received January 27, 2012; Accepted May 24, 2012.
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.
Keywords: Refractory benign esophageal strictures, Fully covered self-expanding metal stents, Biodegradable stents, Self-expanding plastic stents, Expandable esophageal stents
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