title: Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.
abstract: BACKGROUND
  Temporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases.
  
  
  OBJECTIVE
  To evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases.
  
  
  METHODS
  Multicenter retrospective study.
  
  
  METHODS
  Six tertiary care centers in the United States and Europe.
  
  
  METHODS
  A total of 214 patients with benign esophageal diseases undergoing endoscopic stent removal.
  
  
  METHODS
  Endoscopic stent removal.
  
  
  METHODS
  Endoscopic techniques for stent removal, time to stent removal, and adverse events related to stent removal.
  
  
  RESULTS
  A total of 214 patients underwent a total of 329 stent extractions. Stents were mainly placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents, 52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic stents. A total of 35 (10.6%) procedure-related adverse events were reported, including 7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs (P < .001) was a risk factor for adverse events during stent removal. Favorable factors for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194).
  
  
  CONCLUSIONS
  Retrospective analysis, only tertiary care centers.
  
  
  CONCLUSIONS
  With an acceptable major adverse event rate of 2.1%, esophageal stent removal in the setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse events caused by stent removal were not time dependent.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Emo E
authors.initials: EE
authors.lastname: van Halsema
authors.forename: Louis M
authors.initials: LM
authors.lastname: Wong Kee Song
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Frank P
authors.initials: FP
authors.lastname: Vleggaar
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Ginsberg
authors.forename: Pari M
authors.initials: PM
authors.lastname: Shah
authors.forename: David E
authors.initials: DE
authors.lastname: Fleischer
authors.forename: Shiva K
authors.initials: SK
authors.lastname: Ratuapli
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Marcel G W
authors.initials: MG
authors.lastname: Dijkgraaf
authors.forename: Giacomo
authors.initials: G
authors.lastname: Rando
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.forename: Jeanin E
authors.initials: JE
authors.lastname: van Hooft
mesh_terms: D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D004869:Equipment Safety; D004935:Esophageal Diseases / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects