Removal of esophageal expandable metal stents: description of technique and review of potential applications.
BACKGROUND
Expandable metallic stents (EMS) have seen wide application in patients with malignant stricture and fistulas. They have not seen wide application for benign disease because of concern over acute complications and long-term sequelae.


METHODS
Between June 1999 and October 2000, six patients with EMS in place for malignant stricture (n = 3), benign stricture (n = 1), anastomotic leak (n = 1) and benign esophagorespiratory fistula (n = 1) had their stents endoscopically removed. Removal was performed secondarily to the following complications: secondary stricture (n = 1), epidural abscess (n = 1), diskitis (n = 1), resolution of fistula (n = 2), and resolution of anastomotic leak (n = 1).


RESULTS
Four patients had one EMS: Ultraflex (n = 3) and Z-stent (n = 1). In two patients, two stents (Ultraflex and Z-stent) were retrieved simultaneously. No procedurally related complications occurred. Two patients with esophageal cancer required additional stents. All three patients with benign fistula and stricture recovered uneventfully.


CONCLUSIONS
The safe removal of current brands of EMS may facilitate the wider application of these devices to include selective patients with benign disease.
Low
D E
DE
Department of Thoracic Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, C6-SUR, Seattle, WA 98101, USA. donald.low@vmmc.org
Kozarek
R A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011859:Radiography; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends
D008670:Metals