title: Fully versus partially covered self-expandable metal stents in benign esophageal strictures.
abstract: Self-expandable plastic stents are currently recommended for refractory benign esophageal strictures but they show disappointing results in terms of migration and long-term efficacy. We report here our experience in the management of benign esophageal strictures with partially covered (PCSEMS) and fully covered self-expandable metal stents (FCSEMS). We performed a retrospective analysis of self-expandable metal stent (SEMS) placements for benign esophageal strictures from 1998 to 2011 in Rouen University Hospital. Twenty-two patients (15 men, 7 women) attempted 40 esophageal SEMS placements (17 PCSEMS, 23 FCSEMS) during this period. All technical complications were migrations. Migration was noted after 3/17 PCSEMS (17.6%) and 4/23 FCSEMS placement (17.4%, P = ns). Clinical complications occurred after 6/17 PCSEMS and 2/23 FCSEMS placements (35.3% vs. 8.7%, P = 0.053). PCSEMS caused two major complications (fistulae) whereas FCSEMS did not cause any major complication (11.7% vs. 0%). Mean dysphagia score was significantly lower after SEMS placement (1.68 vs. 3.08, P < 0.001) with similar results for PCSEMS and FCSEMS. Stent placement resulted in long-term clinical success for 23.5% of PCSEMS and 34.7% of FCSEMS (P = 0.0505). FCSEMS provide satisfying clinical success rate with an acceptable complication rate and they could constitute a relevant therapeutic option in the management of benign esophageal strictures.
authors.affiliation: Department ofGastroenterology, Rouen University Hospital, Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Gangloff
authors.affiliation: Department ofGastroenterology, Rouen University Hospital, Rouen, France.
authors.forename: S
authors.initials: S
authors.lastname: Lecleire
authors.affiliation: Department ofGastroenterology, Rouen University Hospital, Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Di Fiore
authors.affiliation: Department ofDigestive Surgery, Rouen University Hospital, Rouen, France.
authors.forename: E
authors.initials: E
authors.lastname: Huet
authors.affiliation: Department ofGastroenterology, Rouen University Hospital, Rouen, France.
authors.forename: I
authors.initials: I
authors.lastname: Iwanicki-Caron
authors.affiliation: Department ofGastroenterology, Rouen University Hospital, Rouen, France.
authors.forename: M
authors.initials: M
authors.lastname: Antonietti
authors.affiliation: Department ofGastroenterology, Rouen University Hospital, Rouen, France.
authors.forename: P
authors.initials: P
authors.lastname: Michel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology; D004940:Esophageal Stenosis / Q000150:complications / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: benign esophageal stricture; endoscopy; fully covered self-expandable metal stent; partially covered self-expandable metal stent