D E Low1, R A Kozarek. 1. Department of Thoracic Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, C6-SUR, Seattle, WA 98101, USA. donald.low@vmmc.org
Abstract
BACKGROUND: Expandable metallic stents (EMS) have seen wide application in patients with malignant stricture and fistulas. They have not seen wide application for benign disease because of concern over acute complications and long-term sequelae. METHODS: Between June 1999 and October 2000, six patients with EMS in place for malignant stricture (n = 3), benign stricture (n = 1), anastomotic leak (n = 1) and benign esophagorespiratory fistula (n = 1) had their stents endoscopically removed. Removal was performed secondarily to the following complications: secondary stricture (n = 1), epidural abscess (n = 1), diskitis (n = 1), resolution of fistula (n = 2), and resolution of anastomotic leak (n = 1). RESULTS: Four patients had one EMS: Ultraflex (n = 3) and Z-stent (n = 1). In two patients, two stents (Ultraflex and Z-stent) were retrieved simultaneously. No procedurally related complications occurred. Two patients with esophageal cancer required additional stents. All three patients with benign fistula and stricture recovered uneventfully. CONCLUSIONS: The safe removal of current brands of EMS may facilitate the wider application of these devices to include selective patients with benign disease.
BACKGROUND: Expandable metallic stents (EMS) have seen wide application in patients with malignant stricture and fistulas. They have not seen wide application for benign disease because of concern over acute complications and long-term sequelae. METHODS: Between June 1999 and October 2000, six patients with EMS in place for malignant stricture (n = 3), benign stricture (n = 1), anastomotic leak (n = 1) and benign esophagorespiratory fistula (n = 1) had their stents endoscopically removed. Removal was performed secondarily to the following complications: secondary stricture (n = 1), epidural abscess (n = 1), diskitis (n = 1), resolution of fistula (n = 2), and resolution of anastomotic leak (n = 1). RESULTS: Four patients had one EMS: Ultraflex (n = 3) and Z-stent (n = 1). In two patients, two stents (Ultraflex and Z-stent) were retrieved simultaneously. No procedurally related complications occurred. Two patients with esophageal cancer required additional stents. All three patients with benign fistula and stricture recovered uneventfully. CONCLUSIONS: The safe removal of current brands of EMS may facilitate the wider application of these devices to include selective patients with benign disease.
Authors: Tomas DaVee; Shayan Irani; Cadman L Leggett; Manuel Berzosa Corella; Karina V Grooteman; Louis-Michel Wong Kee Song; Michael B Wallace; Richard A Kozarek; Todd H Baron Journal: Surg Endosc Date: 2015-09-28 Impact factor: 4.584
Authors: Jessica M Leers; Carlo Vivaldi; Hartmut Schäfer; Marc Bludau; Jan Brabender; Georg Lurje; Till Herbold; Arnulf H Hölscher; Ralf Metzger Journal: Surg Endosc Date: 2009-01-28 Impact factor: 4.584
Authors: Gulseren Seven; Shayan Irani; Andrew S Ross; S Ian Gan; Michael Gluck; Donald Low; Richard A Kozarek Journal: Surg Endosc Date: 2013-01-31 Impact factor: 4.584