Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia

Lee, Shigeru; Osugi, Harushi; Tokuhara, Taigo; Takemura, Masashi; Kaneko, Masahiro; Tanaka, Yoshinori; Fujiwara, Yushi; Nishizawa, Satoshi; Iwasaki, Hiroshi; Suehiro, Shigefumi

doi:10.1007/s11748-005-0089-4

Cited by 14 publications

(5 citation statements)

References 13 publications

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“…In contrast to some of previous studies suggesting smaller stent diameter as a risk factor for stent migration, 14,15 our study did not find a statistically significant difference in migration rate based on stent diameter (P = 0.34). It is possible that since the stents used in that study differ from stents studied in ours, the difference in stent design and specification (wire weaving method, design of proximal flare, and radial force) may have contributed to this discrepancy.…”

Section: Discussioncontrasting

confidence: 99%

Predictors of esophageal self-expandable metal stent migration: An academic center study

Jang

Parsi

Collins

et al. 2016

Int J Gastrointest Interv

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Background: Although safe and effective, a wide array of complications of esophageal stent placement continues to pose a significant challenge to clinicians in providing optimal care for their patients. Methods: To identify factors associated with migration of self-expandable metal stent (SEMS) used in treating malignant and benign disease of esophagus, a retrospective study analyzing 105 cases (85 patients) of esophageal SEMS placement between January 2013 and June 2015 was conducted. All cases were performed in a single tertiary referral center. The key outcomes of interest were SEMS migration rates based on indication, stent type, design, and endoscopic findings prior to SEMS placement. Technical success rate, other major adverse outcomes and subgroup analysis of interest were also performed. Results: Overall esophageal SEMS migration rate was 26.7%. Significantly higher rates of stent migration were associated with fully covered stent use (38.1% vs 9.5%, P = 0.001) and stent use in benign conditions (43.9% vs 15.6%, P = 0.002). Our multivariable analysis also showed statistically significant increased risk of migration for SEMS placement in distal esophagus (P = 0.006). Conclusion: This study validated some of previously reported predictors of stent migration. In addition, stent use in benign esophageal disease was found to be a significant risk factor of SEMS migration. Large, prospective studies are necessary to further clarify modifiable risk factors to reduce the rate of SEMS migration.

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Section: Discussioncontrasting

confidence: 99%

Predictors of esophageal self-expandable metal stent migration: An academic center study

Jang

Parsi

Collins

et al. 2016

Int J Gastrointest Interv

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“…Esophageal stent was originally developed to address the surgical treatment of esophageal cancer stenosis, reconstruct the channel, solve patient's nutritional problems and improve the life quality of patients with advanced esophageal cancer. With the development of stent technology, development of covered stent, esophageal stent has been more and more applied in various esophageal fistulas, such as esophageal mediastinal fistula, esophageal tracheal fistula, etc., and achieved good effect ( 13 – 15 ).…”

Section: Discussionmentioning

confidence: 92%

Radiofrequency ablation combined with esophageal stent in the treatment of malignant esophageal stenosis: A single-center prospective study

et al. 2018

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The purpose of this study was to investigate the efficacy of radiofrequency ablation (RFA) combined with esophageal stent in treating malignant esophageal stenosis. Seventy patients with malignant esophageal obstruction treated in Department of Gastroenterology from April 2013 to April 2015 in China-Japan Union Hospital of Jilin University were enrolled. They were randomly assigned into the treatment group (radiofrequency ablation combined with esophageal stent) and control group (esophageal stent). To observe the degree of dysphagia, esophageal stenosis diameter, readmission time, adverse events and complications. There was no significant differences in dysphagia and esophageal diameter between the treatment group and the control group within 1–3 months after operation (P>0.05), and the degree of dysphagia and esophageal diameter in the treatment group at postoperative 6 months were better than those in the control group (P=0.018 and 0.038, respectively). The readmission time of the treatment group was also better than that of the control group (P=0.021). The adverse events and complications included hemorrhage, perforation and esophageal stent displacement. No significant differences in adverse events and complications between the treatment group and the control group were observed. All patients were successfully treated during hospitalization. Effect of radiofrequency ablation combined with esophageal stent implantation was better than esophageal stent implantation in the treatment of malignant esophageal stenosis, but it had no effect on the survival time.

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“…Several studies also have demonstrated the usefulness of stents with antireflux valve. Lee et al50 demonstrated that acid and bile reflux into the esophagus were not detected in patients after placement with an antireflux SEMS. Davies et al51 reported that antireflux Z stent can prevent gastroesophagel reflux.…”

Section: Methodsmentioning

confidence: 99%

Evidence-Based Recommendations on Upper Gastrointestinal Tract Stenting: A Report from the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy

et al. 2013

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Endoscopic stents have evolved dramatically over the past 20 years. With the introduction of uncovered self-expanding metal stents in the early 1990s, they are primarily used to palliate symptoms of malignant obstruction in patients with inoperable gastrointestinal (GI) cancer. At present, stents have emerged as an effective, safe, and less invasive alternative for the treatment of malignant GI obstruction. Clinical decisions about stent placement should be made based on the exact understanding of the patient's condition. These recommendations based on a critical review of the available data and expert consensus are made for the purpose of providing endoscopists with information about stent placement. These can be helpful for management of patients with inoperable cancer or various nonmalignant conditions in the upper GI tract.

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Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia

Abstract: EMS with an antireflux mechanism is not commercially available in Japan and approval is urgently required. The indication of radiotherapy associated with EMS placement is to be studied further.

Cited by 14 publications

References 13 publications

Predictors of esophageal self-expandable metal stent migration: An academic center study

Predictors of esophageal self-expandable metal stent migration: An academic center study

Radiofrequency ablation combined with esophageal stent in the treatment of malignant esophageal stenosis: A single-center prospective study

Evidence-Based Recommendations on Upper Gastrointestinal Tract Stenting: A Report from the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy

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