Self-expanding plastic stents for benign esophageal lesions

Evrard, Sylvie; Moine, Olivier Le; Lazaraki, G.; Dormann, Arno J.; Nakadi, Issam El; Devière, Jacques

doi:10.1016/s0016-5107(04)02278-3

Cited by 197 publications

(148 citation statements)

References 11 publications

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“…Reactive nonmalignant tissue in-or overgrowth is mainly causing a problem when stents are inserted for a longer period and has been reported to occur more commonly with PSEMS than with FSEMS or SEPS. [21][22][23] Experience with temporary stent placement for benign oesophageal ruptures or anastomotic leaks is until now only limited with most studies reporting small case series. In addition, studies comparing SEPS, FSEMS and PSEMS for the treatment of benign oesophageal ruptures and leaks are not available.…”

Section: Discussionmentioning

confidence: 99%

“…392 Pubmed/medline studies Full text retrieval combined (42) Total full text retrieval (31) Total studies retrieved (44) No detailed data on use of stents for benign leaks or ruptures available (19) Total studies for data collection (25) Duplicates (11) Additionally studies detected based on references (13) Full text retrieval (23) Full text retrieval (19) S An absolute prerequisite for healing is adequate drainage of fluid or abscess cavities that are in continuity with the perforation or leak. 24 The time between the occurrence of an oesophageal rupture or leak and the actual treatment, either surgical or endoscopic, is one of the most critical prognostic factors (3;10;12;19).…”

Section: Discussionmentioning

confidence: 99%

“…This is explained by the known reduced anchoring capacity of FSEMS and SEPS compared with PSEMS resulting in an increased migration rate of the former stent type. 23,27 Furthermore, as the far majority of these patients have no obstructive lesion keeping the stent in place, the relatively high rate of stent migration with fully covered stent designs is not unexpected. In contrast, tissue in-and ⁄ or overgrowth was higher with PSEMS (12%) compared with SEPS (3%) and FSEMS (7%) (P = 0.68), although this result was not significant.…”

Section: (98)mentioning

confidence: 99%

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Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus

Boeckel¹,

Sijbring²,

Vleggaar

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

264

232

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Summary Background Placement of self‐expanding metal stents (SEMS) or plastic stents (SEPS) has emerged as a minimally invasive treatment option for benign oesophageal ruptures and leaks; however, it is not clear which stent type should be preferred. Aim To assess clinical effectiveness and safety of treating benign oesophageal ruptures and anastomotic leaks with temporary placement of a stent with special emphasis on different stent designs. Methods A pooled analysis was performed after searching PubMed and EMBASE databases for studies regarding placement of fully covered and partially covered SEMS (FSEMS and PSEMS) and SEPS for this indication. Data were pooled and evaluated for clinical outcome, complications and survival. Results Twenty‐five studies, including 267 patients with complete follow‐up on outcome, were identified. Clinical success was achieved in 85% of patients and was not different between stent types (SEPS 84%, FSEMS 85% and PSEMS 86%, P = 0.97). Time of stent placement was longest for SEPS (8 weeks) followed by FSEMS and PSEMS (both 6 weeks). In total, 65 (34%) patients had a stent‐related complication. Stent migration occurred more often with SEPS [n = 47 (31%)] and FSEMS [n = 7 (26%)] than with PSEMS [n = 2 (12%), P ≤ 0.001], whereas there was no significant difference in tissue in‐ and overgrowth between PSEMS [12% vs. 7% (FSEMS) and 3% (SEPS), P = 0.68]. Conclusions Although there is a lack of randomised controlled trials, it seems that covered stent placement for a period of 6–8 weeks is safe and effective for benign oesophageal ruptures and anastomotic leaks to heal. As efficacy between different stent types is not significantly different, stent choice should depend on expected risk of stent migration (self‐expanding plastic stents and fully covered self‐expanding metal stents) and, to a minor degree, on expected risk of tissue in‐ or overgrowth (partially covered self‐expanding metal stents).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: (98)mentioning

confidence: 99%

See 1 more Smart Citation

Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus

Boeckel¹,

Sijbring²,

Vleggaar

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

264

232

View full text Add to dashboard Cite

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“…This complication was previously reported in an adult patient where the tracheal compression resolved after removal of the stent. 11 Because Berger and Donato 12 in 1972 described the successful use of a Celestin tube to manage leaks in the esophagus, the use of self-expanding plastic esophageal stents for various causes of fistulae and leakages have been well established in adults. Radecke et al 13 have shown that in 73.3 % of patients the leak in the esophagus could be successfully sealed by stent placement.…”

Section: Discussionmentioning

confidence: 99%

Esophageal stent improves ventilation in a child with a broncho‐esophageal fistula caused by Mycobacterium tuberculosis

Goussard

Sidler

Kling

et al. 2006

Pediatric Pulmonology

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Summary. The deployment of an esophageal stent to aid in the ventilation of a child who had developed an acquired broncho-esophageal fistula caused by Mycobacterium tuberculosis (MTB) is described. The 12-month-old boy presented with respiratory failure requiring ventilation. The air leak via the fistula led to inadequate mechanical ventilation. The deployment of the stent resulted in successful ventilation, closure of the fistula, and eventual successful treatment. Pediatr Pulmonol. 2007; 42:93-97. ß

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“…Fac− tors which might have increased the risk of serious complications in this case in− clude: female gender, prior radiation therapy [1], proximal stricture location [2], kyphosis [3], and intestinal metapla− sia [4]. While removable self−expanding plastic stents are a promising tool in the treatment of refractory benign esopha− geal stricture [5], caution is warranted with prolonged placement. Further data regarding their long−term safety, compar− ison with other management strategies, and identification of risk factors for se− rious complications are required.…”

mentioning

confidence: 99%

Aortoesophageal fistula following Polyflex stent placement for refractory benign esophageal stricture

Rogart¹,

Greenwald²,

Rossi³

et al. 2007

Endoscopy

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Self-expanding plastic stents for benign esophageal lesions

Cited by 197 publications

References 11 publications

Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus

Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus

Esophageal stent improves ventilation in a child with a broncho‐esophageal fistula caused by Mycobacterium tuberculosis

Aortoesophageal fistula following Polyflex stent placement for refractory benign esophageal stricture

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