BACKGROUND: The use of fully covered self-expandable metallic stents (FCSEMS) has opened the door to treat stenosis in the post-bariatric stomach. We hypothesized that endoscopically securing a FCSEMS would be technically feasible, effective, and safe for > 30-day dwell time. OBJECTIVES: To assess the technical feasibility, clinical efficacy, and safety of endoscopically secured FCSEMS in the stomach for > 30 days. METHODS: A retrospective review (September 2016 to April 2018) of consecutive patients who underwent FCSEMS suturing in the stomach at a single academic institution was reviewed. Technical success, stent dwell time, symptoms, and adverse events were recorded. RESULTS: Fifteen patients (median age of 49 (31-70)) were included. Stents were inserted for gastrojejunal (GJ) stricture or gastric stenosis in 9/15 and 6/15 of patients, respectively. All procedures were technically successful (100%). Immediate and short-term clinical success (prior to stent removal) was 100% in patients who did not have stent migration. Stent migration was seen in 3 cases (20%) after a median dwell time of 211 days. However, 2/3 (66.6%) had not attended their scheduled removal. Recurrence of symptoms after stent removal was seen in 53.3% of patients with 40% undergoing repeat stenting. Median stent dwell was 117 (30-342) days. Sixty percent and 33% of patients had stent dwell of at least 90 and 180 days, respectively. CONCLUSIONS: A FCSEMS, if secured, may be safe and effective for even > 90-day dwell time in the post-bariatric stomach and may result in long-term clinical success for GJ stricture after stent removal.
BACKGROUND: The use of fully covered self-expandable metallic stents (FCSEMS) has opened the door to treat stenosis in the post-bariatric stomach. We hypothesized that endoscopically securing a FCSEMS would be technically feasible, effective, and safe for > 30-day dwell time. OBJECTIVES: To assess the technical feasibility, clinical efficacy, and safety of endoscopically secured FCSEMS in the stomach for > 30 days. METHODS: A retrospective review (September 2016 to April 2018) of consecutive patients who underwent FCSEMS suturing in the stomach at a single academic institution was reviewed. Technical success, stent dwell time, symptoms, and adverse events were recorded. RESULTS: Fifteen patients (median age of 49 (31-70)) were included. Stents were inserted for gastrojejunal (GJ) stricture or gastric stenosis in 9/15 and 6/15 of patients, respectively. All procedures were technically successful (100%). Immediate and short-term clinical success (prior to stent removal) was 100% in patients who did not have stent migration. Stent migration was seen in 3 cases (20%) after a median dwell time of 211 days. However, 2/3 (66.6%) had not attended their scheduled removal. Recurrence of symptoms after stent removal was seen in 53.3% of patients with 40% undergoing repeat stenting. Median stent dwell was 117 (30-342) days. Sixty percent and 33% of patients had stent dwell of at least 90 and 180 days, respectively. CONCLUSIONS: A FCSEMS, if secured, may be safe and effective for even > 90-day dwell time in the post-bariatric stomach and may result in long-term clinical success for GJ stricture after stent removal.
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: Reem Z Sharaiha; Katherine J Kim; Vikesh K Singh; Anne Marie Lennon; Stuart K Amateau; Eun Ji Shin; Marcia Irene Canto; Anthony N Kalloo; Mouen A Khashab Journal: Surg Endosc Date: 2013-09-07 Impact factor: 4.584
Authors: Mouen A Khashab; Sepideh Besharati; Saowanee Ngamruengphong; Vivek Kumbhari; Mohamad El Zein; Ellen M Stein; Alan Tieu; Gerard E Mullin; Sameer Dhalla; Monica C Nandwani; Vikesh Singh; Marcia I Canto; Anthony N Kalloo; John O Clarke Journal: Gastrointest Endosc Date: 2015-08-05 Impact factor: 9.427
Authors: Steve Eubanks; Christopher A Edwards; Nicole M Fearing; Archana Ramaswamy; Roger A de la Torre; Klaus J Thaler; Brent W Miedema; James S Scott Journal: J Am Coll Surg Date: 2008-05 Impact factor: 6.113