title: Endoscopic clips prevent self-expandable metallic stent migration.
abstract: OBJECTIVE
  Self-expandable metallic stents (SEMS) have been used for many years in the palliation of esophageal cancer symptoms. Stent migration is one of the most recognized complications of SEMS. To prevent SEMS migration, this study reported the use of endoscopic clips, and carefully analyzed the patients who underwent implantation.
  
  
  METHODS
  From January 2000 to December 2002, nine patients consecutively underwent SEMS implantation. After successful placement of the SEMS and to maintain its position, endoscopic clips were used to fix the branch of the upper end of the stent to the esophageal mucosa.
  
  
  RESULTS
  Stent implantation was technically successful in all patients, three of whom had strictures and six of whom had digestive-respiratory fistulas. No stent migration was observed in any of the patients, and dysphagia improved significantly after stent placement. Five patients did, however, experience delayed complications, two in the form of obstructions, two with recurrent fistulas, and one with a perforation.
  
  
  CONCLUSIONS
  In conclusion, this new technique is recommended as endoscopic clipping can diminish the risks of stent migration, in particular those associated with esophago-respiratory fistulas without luminal obstruction.
authors: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, Maebashi, Japan. hiroyuki@po.wind.ne.jp
authors: Hiroyuki
authors: H
authors: Kato
authors: Minoru
authors: M
authors: Fukuchi
authors: Tatsuya
authors: T
authors: Miyazaki
authors: Ryokuhei
authors: R
authors: Manda
authors: Ahmad
authors: A
authors: Faried
authors: Junko
authors: J
authors: Takita
authors: Masanobu
authors: M
authors: Nakajima
authors: Makoto
authors: M
authors: Sohda
authors: Yasuyuki
authors: Y
authors: Fukai
authors: Norihiro
authors: N
authors: Masuda
authors: Katsuhiko
authors: K
authors: Tsukada
authors: Hiroyuki
authors: H
authors: Kuwano
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents / Q000009:adverse effects*