title: Comparison of a standard fully covered stent with a super-thick silicone-covered stent for the treatment of refractory esophageal benign strictures: A prospective multicenter study.
abstract: BACKGROUND
  Some esophageal strictures resist endoscopic treatments. There is a need for new treatments, such as specifically designed stents.
  
  
  OBJECTIVE
  Our study sought to compare the results achieved with a standard, fully covered metallic stent (FCMS) and those achieved using a stent designed specifically for benign strictures (BS-FCMS).
  
  
  METHODS
  The study used a prospective, multicenter, controlled design, with patients recruited from tertiary referral centers. Patients with refractory esophageal strictures were included. Standard FCMS were used in group 1 (N = 24), and BS-FCMS were used in group 2 (N = 17). Patients were followed for 24 months after stent removal. The main outcomes measured were stricture resolution rate, 24 months' recurrence rate and stent-related morbidity.
  
  
  RESULTS
  Early stent migrations occurred in one (4.1%) patient from group 1 and five (29.4%) from group 2 (p < 0.05). During esophageal stenting, complications occurred in six patients (25%) in group 1 and six patients (35.3%) in group 2 (p = 0.47), respectively. Fifty percent of complications were attributed to migration. There was no procedure-related morbidity associated with the extraction of the stent. The stricture resolution rate was, respectively, 95.2% in group 1 and 87.5% in group 2 (the difference between the two groups is not significant). During follow-up, stricture recurrence occurred in 15/19 patients (group 1, 79%) and 7/8 patients (group 2, 87.5%; p = 1.0). The median time to recurrence of esophageal stricture was 1.7 months (group 1, 0.6-12 months) and 1 month (group 2, 0.1-6 months). Study limitations include its nonrandomized design.
  
  
  CONCLUSIONS
  The stricture resolution rate was high at the end of the stenting period for both types of stents without any statistical difference between the two groups, but the long-term results were disappointing, with stricture recurring frequently and rapidly in both groups.
authors.affiliation: Hepato-gastroenterology Department, Université Paris-Descartes, Hôpital Cochin, Paris, France.
authors.forename: Ulriikka
authors.initials: U
authors.lastname: Chaput
authors.affiliation: Hepato-gastroenterology Department, Hôpital Pontchaillou, Rennes, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Heresbach
authors.affiliation: Biostatistical and Epidemiology Unit, Hôpital Hôtel Dieu, Université Paris Descartes, Paris, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.affiliation: Hepato-gastroenterology Department, Hôpital de l'Archet, Nice, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Vanbiervliet
authors.affiliation: Hepato-gastroenterology Department, Université Paris-Descartes, Hôpital Cochin, Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gaudric
authors.affiliation: Hepato-gastroenterology Department, Centre Hospitalier Universitaire La Tronche, Grenoble, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bichard
authors.affiliation: Hepato-gastroenterology Department, Hôpital Saint Eloi, Montpellier, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Bauret
authors.affiliation: Hepato-gastroenterology Department, Hôpital Civil de Strasbourg, Strasbourg, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Coumaros
authors.affiliation: Hepato-gastroenterology Department, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
authors.affiliation: Hepato-gastroenterology Department, Centre Hospitalier Universitaire de Saint-Etienne, Hôpital Nord, Saint Priest en Jarez, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Fumex
authors.affiliation: Hepato-gastroenterology Department, Clinique de l'Alma, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bensoussan
authors.affiliation: Hepato-gastroenterology Department, Hôpital Saint-André, Bordeaux, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Lamouliatte
authors.affiliation: Hepato-gastroenterology Department, Université Paris-Descartes, Hôpital Cochin, Paris, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Chryssostalis
authors.affiliation: Société Française d'Endoscopie Digestive, Lyon and Paris, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Robin
authors.affiliation: Hepato-gastroenterology Department, Université Paris-Descartes, Hôpital Cochin, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Prat
keywords: Benign esophageal stricture; fully covered self-expandable metallic stent; refractory stricture