Ulriikka Chaput1, Denis Heresbach2, Etienne Audureau3, Geoffroy Vanbiervliet4, Marianne Gaudric1, Philippe Bichard5, Paul Bauret6, Dimitri Coumaros7, Thierry Ponchon8, Fabien Fumex9, Emmanuel Bensoussan10, Hervé Lamouliatte11, Ariane Chryssostalis1, Françoise Robin12, Frédéric Prat1. 1. Hepato-gastroenterology Department, Université Paris-Descartes, Hôpital Cochin, Paris, France. 2. Hepato-gastroenterology Department, Hôpital Pontchaillou, Rennes, France. 3. Biostatistical and Epidemiology Unit, Hôpital Hôtel Dieu, Université Paris Descartes, Paris, France. 4. Hepato-gastroenterology Department, Hôpital de l'Archet, Nice, France. 5. Hepato-gastroenterology Department, Centre Hospitalier Universitaire La Tronche, Grenoble, France. 6. Hepato-gastroenterology Department, Hôpital Saint Eloi, Montpellier, France. 7. Hepato-gastroenterology Department, Hôpital Civil de Strasbourg, Strasbourg, France. 8. Hepato-gastroenterology Department, Hôpital Edouard Herriot, Lyon, France. 9. Hepato-gastroenterology Department, Centre Hospitalier Universitaire de Saint-Etienne, Hôpital Nord, Saint Priest en Jarez, France. 10. Hepato-gastroenterology Department, Clinique de l'Alma, Paris, France. 11. Hepato-gastroenterology Department, Hôpital Saint-André, Bordeaux, France. 12. Société Française d'Endoscopie Digestive, Lyon and Paris, France.
Abstract
BACKGROUND: Some esophageal strictures resist endoscopic treatments. There is a need for new treatments, such as specifically designed stents. OBJECTIVE: Our study sought to compare the results achieved with a standard, fully covered metallic stent (FCMS) and those achieved using a stent designed specifically for benign strictures (BS-FCMS). PATIENTS AND METHODS: The study used a prospective, multicenter, controlled design, with patients recruited from tertiary referral centers. Patients with refractory esophageal strictures were included. Standard FCMS were used in group 1 (N = 24), and BS-FCMS were used in group 2 (N = 17). Patients were followed for 24 months after stent removal. The main outcomes measured were stricture resolution rate, 24 months' recurrence rate and stent-related morbidity. RESULTS: Early stent migrations occurred in one (4.1%) patient from group 1 and five (29.4%) from group 2 (p < 0.05). During esophageal stenting, complications occurred in six patients (25%) in group 1 and six patients (35.3%) in group 2 (p = 0.47), respectively. Fifty percent of complications were attributed to migration. There was no procedure-related morbidity associated with the extraction of the stent. The stricture resolution rate was, respectively, 95.2% in group 1 and 87.5% in group 2 (the difference between the two groups is not significant). During follow-up, stricture recurrence occurred in 15/19 patients (group 1, 79%) and 7/8 patients (group 2, 87.5%; p = 1.0). The median time to recurrence of esophageal stricture was 1.7 months (group 1, 0.6-12 months) and 1 month (group 2, 0.1-6 months). Study limitations include its nonrandomized design. CONCLUSION: The stricture resolution rate was high at the end of the stenting period for both types of stents without any statistical difference between the two groups, but the long-term results were disappointing, with stricture recurring frequently and rapidly in both groups.
BACKGROUND: Some esophageal strictures resist endoscopic treatments. There is a need for new treatments, such as specifically designed stents. OBJECTIVE: Our study sought to compare the results achieved with a standard, fully covered metallic stent (FCMS) and those achieved using a stent designed specifically for benign strictures (BS-FCMS). PATIENTS AND METHODS: The study used a prospective, multicenter, controlled design, with patients recruited from tertiary referral centers. Patients with refractory esophageal strictures were included. Standard FCMS were used in group 1 (N = 24), and BS-FCMS were used in group 2 (N = 17). Patients were followed for 24 months after stent removal. The main outcomes measured were stricture resolution rate, 24 months' recurrence rate and stent-related morbidity. RESULTS: Early stent migrations occurred in one (4.1%) patient from group 1 and five (29.4%) from group 2 (p < 0.05). During esophageal stenting, complications occurred in six patients (25%) in group 1 and six patients (35.3%) in group 2 (p = 0.47), respectively. Fifty percent of complications were attributed to migration. There was no procedure-related morbidity associated with the extraction of the stent. The stricture resolution rate was, respectively, 95.2% in group 1 and 87.5% in group 2 (the difference between the two groups is not significant). During follow-up, stricture recurrence occurred in 15/19 patients (group 1, 79%) and 7/8 patients (group 2, 87.5%; p = 1.0). The median time to recurrence of esophageal stricture was 1.7 months (group 1, 0.6-12 months) and 1 month (group 2, 0.1-6 months). Study limitations include its nonrandomized design. CONCLUSION: The stricture resolution rate was high at the end of the stenting period for both types of stents without any statistical difference between the two groups, but the long-term results were disappointing, with stricture recurring frequently and rapidly in both groups.
Authors: Mohamad A Eloubeidi; Jayant P Talreja; Tercio L Lopes; Basil S Al-Awabdy; Vanessa M Shami; Michel Kahaleh Journal: Gastrointest Endosc Date: 2011-01-26 Impact factor: 9.427
Authors: Gum Mo Jung; Seung Hyun Lee; Dae Seong Myung; Wan Sik Lee; Young Eun Joo; Mi Ran Jung; Seong Yeob Ryu; Young Kyu Park; Sung Bum Cho Journal: J Gastric Cancer Date: 2018-02-20 Impact factor: 3.720