title: The role of biodegradable stents in the management of benign and malignant oesophageal strictures: A cohort study.
abstract: BACKGROUND
  Oesophageal strictures can be caused by benign or malignant processes. Up to 10% of patients with a benign stricture are refractory to pneumatic dilatation and may benefit from biodegradable stent (BD) insertion. Biodegradable stents also have a role in malignant oesophageal strictures to facilitate enteral nutrition while staging or neo-adjuvant treatment is completed. The aim of this study was to review the safety and efficacy of BD stents in the management of benign or malignant oesophageal strictures.
  
  
  METHODS
  A single centre retrospective cohort study was performed. Dysphagia was graded before and after stenting using a validated score. All patients were followed up for at least 30 days and all adverse events were recorded.
  
  
  RESULTS
  Twenty eight stents were inserted in 20 patients; 11 for malignant and 17 for benign disease. One further attempted stenting was impossible due to a high benign stricture. There were no perforations and the 30-day mortality rate was zero. Mean dysphagia scores improved from 2.65 to 1.00 (p value <0.001) in benign disease and from 3.27 to 1.36 (p value <0.001) in patients with malignant disease. Surgical resection was not compromised following stent insertion in the malignant group.
  
  
  CONCLUSIONS
  Biodegradable stent insertion is a safe and efficacious adjunct in the treatment of benign and malignant oesophageal strictures. In malignant disease, BD stent insertion can maintain enteral nutrition while staging or neo-adjuvant therapy is completed without adversely impacting on surgical resection.
authors.affiliation: Departments of General Surgery, Craigavon Area Hospital, Craigavon, Northern Ireland, UK. Electronic address: smccain02@qub.ac.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: McCain
authors.affiliation: Departments of General Surgery, Craigavon Area Hospital, Craigavon, Northern Ireland, UK.
authors.forename: Scott
authors.initials: S
authors.lastname: McCain
authors.affiliation: Departments of Radiology, Craigavon Area Hospital, Craigavon, Northern Ireland, UK.
authors.forename: Barry
authors.initials: B
authors.lastname: Quinn
authors.affiliation: Departments of General Surgery, Craigavon Area Hospital, Craigavon, Northern Ireland, UK; Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.
authors.forename: Ronan
authors.initials: R
authors.lastname: Gray
authors.affiliation: Departments of Radiology, Craigavon Area Hospital, Craigavon, Northern Ireland, UK.
authors.forename: Joan
authors.initials: J
authors.lastname: Morton
authors.affiliation: Departments of Radiology, Craigavon Area Hospital, Craigavon, Northern Ireland, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Rice
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D004867:Equipment Design; D004940:Esophageal Stenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Benign stricture; Biodegradable stent; Malignant stricture; Oesophageal stricture