Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures.
BACKGROUND
Benign, refractory esophageal strictures are an important therapeutic challenge. Metal stents occasionally have been used, but results have been disappointing. The present study assessed the safety and the efficacy of temporary placement of the new expandable polyester silicone-covered stent for management of problematic esophageal strictures.


METHODS
Fifteen patients with benign esophageal strictures were treated by temporary (6 weeks) placement of an expandable polyester silicone-covered stent. All patients had previously been treated, unsuccessfully, by repetitive endoscopic dilation.


RESULTS
Stent placement was successful in all patients. There was no procedure-related complication. Dilation with over-the-guidewire polyvinyl dilators was required before stent placement. With the stent in situ, dysphagia completely resolved in all patients. Six weeks after placement, one stent was found to have migrated into the stomach. In the remaining patients, the stent was easily removed with a foreign body forceps. The pretreatment dysphagia score was 3 (range 2-4); the post-treatment score was 1 (range 0-1) (p < 0.0005). Long-term resolution (mean follow-up 22.7 [2.6] months) of the stricture was achieved in 12 patients (80%). The treatment failed in 3 patients, all of whom continue to require periodic dilation.


CONCLUSIONS
In patients with benign esophageal strictures refractory to conventional dilation, temporary placement of a removable expandable polyester silicone-covered stent may lead to long-term relief of dysphagia with minimal morbidity.
Department of Gastroenterology and Clinical Nutrition, Molinette Hospital, Torino, Italy.
Alessandro
A
Repici
Massimo
M
Conio
Claudio
C
De Angelis
Edda
E
Battaglia
Alessandro
A
Musso
Rinaldo
R
Pellicano
Matteo
M
Goss
Giovanna
G
Venezia
Mario
M
Rizzetto
Giorgio
G
Saracco
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000628:therapy; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011475:Prosthesis Failure; D011859:Radiography; D012828:Silicones; D015607:Stents; D016896:Treatment Outcome
D011091:Polyesters; D012828:Silicones