Self-expanding plastic stents for benign esophageal lesions.
BACKGROUND
A benign condition is a relative contraindication to the use of self-expanding metallic stents, because these devices usually are not retrievable. The self-expanding plastic stent is removable and induces less tissue hyperplasia. This study prospectively evaluated the use of a self-expanding plastic stent to treat benign esophageal conditions.


METHODS
Over 4 years, 21 patients underwent self-expanding plastic stent placement for various benign esophageal disorders, including refractory peptic (n = 2), caustic (n = 3), post-radiotherapy (n = 3), and anastomotic (n = 4) stenoses; hyperplastic (n = 5) stenosis within a previously implanted metallic stent; and anastomotic leak (n = 4) after esophagectomy. The self-expanding plastic stent was removed from all patients. Patients were followed for at least 8 months after stent removal.


RESULTS
Implantation was successful in all cases. Temporary self-expanding plastic stent placement was curative in 17/21 patients, especially those with caustic and hyperplastic strictures and anastomotic fistula, all of which were treated successfully without re-intervention. Median follow-up was 21 months (range 8-39 months) after stent removal. Moreover, by inducing tissue ischemia, self-expanding plastic stent allowed delayed removal of metallic stents. Only one severe complication (tracheal compression) was encountered, and this resolved after stent removal.


CONCLUSIONS
A range of benign stenosing disorders of the esophagus can be treated safely with a self-expanding plastic stent. Because the long-term results were highly favorable, self-expanding plastic stent placement could be used as the initial treatment for various conditions. Self-expanding plastic stent insertion within an esophageal self-expanding metallic stent allowed removal of the latter, theoretically unretrievable, stent.
Evrard
Sylvie
S
Department of Gastroenterology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium.
Le Moine
Olivier
O
Lazaraki
Giorgia
G
Dormann
Arno
A
El Nakadi
Issam
I
Devière
Jacques
J
D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D002424:Caustics; D002675:Child, Preschool; D020878:Device Removal; D004935:Esophageal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D004947:Esophagus / Q000293:injuries; D005500:Follow-Up Studies; D006801:Humans; D008670:Metals; D008875:Middle Aged; D010969:Plastics; D011859:Radiography; D019233:Retreatment; D015607:Stents; D014945:Wound Healing / Q000502:physiology
D002424:Caustics; D008670:Metals; D010969:Plastics