Polyflex self-expanding, removable plastic stents: assessment of treatment efficacy and safety in a variety of benign and malignant conditions of the esophagus.
BACKGROUND
Historically, esophageal fistulas, perforations, and benign and malignant strictures have been managed surgically or with the placement of permanent endoprostheses or metallic stents. Recently, a removable, self-expanding, plastic stent has become available. The authors investigated the use of this new stent at their institution.


METHODS
The study reviewed all the patients who received a Polyflex stent for an esophageal indication at the authors' institution between January 2004 and October 2006. Duration of placement, complications, and treatment efficacy were recorded.


RESULTS
A total of 37 stents were placed in 30 patients (14 women and 16 men) with a mean age of 68 years (range, 28-92 years). Stent placement included 7 for fistulas, 3 for perforations, 1 for an anastomotic leak, 7 for malignant strictures, and 19 for benign strictures (8 anastomotic, 1 caustic, 5 reflux, 2 radiation, and 2 autoimmune esophagitis strictures, and 1 post-Nissen gas bloat stricture). The mean follow-up period was 6 months. Stent deployment was successful for all the patients, and no complications resulted from stent placement or removal. Nine stents migrated spontaneously. Three of three perforations and three of five fistulas sealed. Only one stent was removed because of patient discomfort. One patient with a radiation stricture experienced tracheoesophageal fistulas secondary to pressure necrosis. Of 20 patients with stricture, 18 experienced improvement in their dysphagia.


CONCLUSIONS
Self-expanding, removable plastic stents are easily and safely placed and removed from the esophagus. This has facilitated their use in the authors' institution for an increasing number of esophageal conditions. Further studies to help define their ultimate role in benign and malignant esophageal pathology are warranted.
Karbowski
M
M
Department of Thoracic Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, USA. resm4k@vmmc.org
Schembre
D
D
Kozarek
R
R
Ayub
K
K
Low
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use; D020878:Device Removal; D004935:Esophageal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters / Q000627:therapeutic use; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D015641:Radiography, Interventional / Q000009:adverse effects; D012189:Retrospective Studies; D012828:Silicones / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011091:Polyesters; D012828:Silicones