Vinit Kahalekar1, Deepak Trilokinath Gupta2, Pratin Bhatt1, Akash Shukla1, Shobna Bhatia1. 1. Department of Gastroenterology, Seth G S Medical College and K E M Hospital, Parel, Mumbai, 400 012, India. 2. Department of Gastroenterology, Seth G S Medical College and K E M Hospital, Parel, Mumbai, 400 012, India. dkgt@rediffmail.com.
Abstract
AIMS: Treatment options for benign refractory esophageal stricture are limited. We retrospectively analyzed data of 11 patients who underwent fully covered self-expanding metallic stent (FC-SEMS) placement for refractory benign esophageal stricture at our institute. METHODS: Refractory benign esophageal stricture was defined as inability to dilate a stricture to a diameter of 14 mm after a minimum of five sessions at 2-week intervals or inability to maintain diameter of 14 mm for at least 4 weeks. Eleven patients with refractory benign esophageal stricture (corrosive-6, peptic-3, and post-sclerotherapy-2) underwent FC-SEMS placement. The stent was removed after 4-6 weeks as per manufacturer's recommendation. Patients were followed up for 1 year. RESULTS: Three patients with peptic strictures [length of stricture 2, 3, and 3 cm] and two patients with post-sclerotherapy stricture [length 2 and 1.5 cm] had complete response. Two of 6 patients with corrosive stricture (10 cm, 12 cm) developed recurrence of symptoms within 1 month of stent removal, and two after 2 months (8 cm, 3 cm). One patient with corrosive stricture (6 cm) had recurrence after 6 months, and responded to single session of dilatation. One patient with corrosive stricture was asymptomatic for last 12 months. Four stents were migrated. Four patients developed severe retrosternal pain following stent placement, which was managed with analgesics. There were no serious adverse events after placement of stent and removal of stent. CONCLUSIONS: Fully covered SEMS is safe and effective for refractory benign non-corrosive esophageal strictures.
AIMS: Treatment options for benign refractory esophageal stricture are limited. We retrospectively analyzed data of 11 patients who underwent fully covered self-expanding metallic stent (FC-SEMS) placement for refractory benign esophageal stricture at our institute. METHODS: Refractory benign esophageal stricture was defined as inability to dilate a stricture to a diameter of 14 mm after a minimum of five sessions at 2-week intervals or inability to maintain diameter of 14 mm for at least 4 weeks. Eleven patients with refractory benign esophageal stricture (corrosive-6, peptic-3, and post-sclerotherapy-2) underwent FC-SEMS placement. The stent was removed after 4-6 weeks as per manufacturer's recommendation. Patients were followed up for 1 year. RESULTS: Three patients with peptic strictures [length of stricture 2, 3, and 3 cm] and two patients with post-sclerotherapy stricture [length 2 and 1.5 cm] had complete response. Two of 6 patients with corrosive stricture (10 cm, 12 cm) developed recurrence of symptoms within 1 month of stent removal, and two after 2 months (8 cm, 3 cm). One patient with corrosive stricture (6 cm) had recurrence after 6 months, and responded to single session of dilatation. One patient with corrosive stricture was asymptomatic for last 12 months. Four stents were migrated. Four patients developed severe retrosternal pain following stent placement, which was managed with analgesics. There were no serious adverse events after placement of stent and removal of stent. CONCLUSIONS: Fully covered SEMS is safe and effective for refractory benign non-corrosive esophageal strictures.
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: S L Broor; A Kumar; S T Chari; A Singal; S P Misra; N Kumar; S K Sarin; J C Vij Journal: J Gastroenterol Hepatol Date: 1989 Jan-Feb Impact factor: 4.029
Authors: Jorge Manuel Tavares Canena; Manuel José Antunes Liberato; Ricardo António Natário Rio-Tinto; Pedro Miguel Pinto-Marques; Carlos Manuel Menezes Romão; António Vasco Mello Pereira Coutinho; Beatriz Alda Henriques Costa Neves; Maria Filipa Costa Neves Santos-Silva Journal: BMC Gastroenterol Date: 2012-06-12 Impact factor: 3.067