title: Fully covered self-expanding metal stents for benign colonic strictures.
abstract: OBJECTIVE
  Uncovered self-expanding metal stents offer effective relief for colonic obstruction. The aim of this study was to determine the effectiveness of fully covered self-expanding metal stents (FCSEMSs) in the treatment of benign colonic strictures.
  
  
  METHODS
  All patients presenting with a symptomatic benign colonic stricture (occlusion or subocclusion) during a 6-year study period were treated with FCSEMSs. The stents were placed and removed 4 - 6 weeks later at one of 10 endoscopy centers. The efficacy of the stent (clinical and radiological signs of colonic decompression within 48 hours), technical success, stent retrieval, safety, and recurrence of symptoms were evaluated during follow-up. Univariate and multivariate analyses were performed to identify variables associated with clinical success, stent migration, and symptom recurrence.
  
  
  RESULTS
  The study included 43 patients (24 men, 19 women; mean age 67.6 ± 10.4) with occlusive (n = 18) or subocclusive symptoms (n = 25) due to anastomotic (n = 40), post-ischemic (n = 2), or post-radiation (n = 1) strictures. Insertion was successful in all patients. Clinical success was obtained in 35 patients (81 %). Migration was observed in 27 patients (63 %). The median duration of stenting was 21 days (95 %CI 17.8 - 35.4 days). Multivariate analysis showed that stents more than 20 mm wide migrated significantly less often. Recurrence of obstructive symptoms was observed in 23 patients (53 %), irrespective of migration. No predictive factors for recurrence or clinical efficacy were found.
  
  
  CONCLUSIONS
  FCSEMSs for treatment of symptomatic benign colonic strictures are safe and effective, despite a high rate of spontaneous migration.
authors.affiliation: Faculty of Medicine, University of Nice Sophia-Antipolis, Nice, France. vanbiervliet.g@chu-nice.fr
authors.forename: G
authors.initials: G
authors.lastname: Vanbiervliet
authors.forename: P
authors.initials: P
authors.lastname: Bichard
authors.forename: J-F
authors.initials: JF
authors.lastname: Demarquay
authors.forename: E
authors.initials: E
authors.lastname: Ben-Soussan
authors.forename: S
authors.initials: S
authors.lastname: Lecleire
authors.forename: K
authors.initials: K
authors.lastname: Barange
authors.forename: J-M
authors.initials: JM
authors.lastname: Canard
authors.forename: H
authors.initials: H
authors.lastname: Lamouliatte
authors.forename: E
authors.initials: E
authors.lastname: Fontas
authors.forename: M
authors.initials: M
authors.lastname: Barthet
authors.forename: T
authors.initials: T
authors.lastname: Ponchon
authors.forename: J-C
authors.initials: JC
authors.lastname: Saurin
mesh_terms: D000368:Aged; D003108:Colonic Diseases / Q000628:therapy*; D020878:Device Removal; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D008670:Metals; D012008:Recurrence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals