Fully covered self-expanding metal stents are effective for benign esophagogastric disruptions and strictures.
OBJECTIVE
Self-expanding fully covered metal stents (CSs) are ideal for use in benign esophagogastric disease. We reviewed our experience with CS to evaluate outcomes, to determine a role for CS in a standard treatment for benign esophageal conditions, and to compare our results with recently published studies.


METHODS
We performed a retrospective chart review from 2005 to 2012.


RESULTS
A total of 57 CSs were placed in 44 patients. Indications were stricture (11 patients), anastomotic leak (20), perforation (7), and tracheoesophageal fistulae (6). For GI tract disruptions, open repair or diversion was avoided in 31/33 patients (93.9 %) but required an associated drainage procedure in 22/33 (67 %) patients. Resolution does not depend on achieving radiological control with 6/26 (23 %) having evidence of a persistent leak. Benign strictures were dilated at a mean of 3.7 times prior to stenting. Adjunctive intra-mucosal steroid injections were used in 8/11 patients. Stents were removed at a mean of 33 days. At a mean of 283 days of follow-up, 6/11 (54.5 %) had symptom resolution. The most common complication was stent migration occurring in 17.5 % of patients overall.


CONCLUSIONS
Covered stents are an effective adjunct in the management of benign upper gastrointestinal tract fistulae, leaks, perforations and benign strictures.
Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, USA.
Jennifer L
JL
Wilson
Brian E
BE
Louie
Alexander S
AS
Farivar
Eric
E
Vallières
Ralph W
RW
Aye
D057868:Anastomotic Leak / Q000601:surgery*; D004322:Drainage / Q000379:methods; D004939:Esophageal Perforation / Q000601:surgery; D004940:Esophageal Stenosis / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D014138:Tracheoesophageal Fistula / Q000601:surgery*