Endoscopy 2013; 45(01): 35-41
DOI: 10.1055/s-0032-1325769
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Fully covered self-expanding metal stents for benign colonic strictures

G. Vanbiervliet
Faculty of Medicine, University of Nice Sophia-Antipolis, Nice, France
Department of Gastroenterology, University Hospital of Nice, Nice, France
,
P. Bichard
University Hospital of Grenoble, Grenoble, France
,
J.-F. Demarquay
Princess Grace Hospital, Principality of Monaco
,
E. Ben-soussan
Clinic of l’Alma, Paris, France
,
S. Lecleire
University Hospital of Rouen, Rouen, France
,
K. Barange
University Hospital of Toulouse, Toulouse, France
,
J.-M. Canard
Clinic of Trocadéro, Paris, France
,
H. Lamouliatte
University Hospital of Bordeaux, Bordeaux, France
,
E. Fontas
Faculty of Medicine, University of Nice Sophia-Antipolis, Nice, France
Department of Research, University Hospital of Nice, Nice, France
,
M. Barthet
Department of Gastroenterology, Public Assistance Hospitals of Marseille, Marseille, France
,
T. Ponchon
Hospices civils of Lyon, Lyon, France
,
J.-C. Saurin
Hospices civils of Lyon, Lyon, France
,
; on behalf of the Research Committee of the French Society of Digestive Endoscopy (SFED)› Author Affiliations
Further Information

Publication History

submitted 13 April 2012

accepted after revision 04 August 2012

Publication Date:
07 November 2012 (eFirst)

Background and study aims: Uncovered self-expanding metal stents offer effective relief for colonic obstruction. The aim of this study was to determine the effectiveness of fully covered self-expanding metal stents (FCSEMSs) in the treatment of benign colonic strictures.

Patients and methods: All patients presenting with a symptomatic benign colonic stricture (occlusion or subocclusion) during a 6-year study period were treated with FCSEMSs. The stents were placed and removed 4 – 6 weeks later at one of 10 endoscopy centers. The efficacy of the stent (clinical and radiological signs of colonic decompression within 48 hours), technical success, stent retrieval, safety, and recurrence of symptoms were evaluated during follow-up. Univariate and multivariate analyses were performed to identify variables associated with clinical success, stent migration, and symptom recurrence.

Results: The study included 43 patients (24 men, 19 women; mean age 67.6 ± 10.4) with occlusive (n = 18) or subocclusive symptoms (n = 25) due to anastomotic (n = 40), post-ischemic (n = 2), or post-radiation (n = 1) strictures. Insertion was successful in all patients. Clinical success was obtained in 35 patients (81 %). Migration was observed in 27 patients (63 %). The median duration of stenting was 21 days (95 %CI 17.8 – 35.4 days). Multivariate analysis showed that stents more than 20 mm wide migrated significantly less often. Recurrence of obstructive symptoms was observed in 23 patients (53 %), irrespective of migration. No predictive factors for recurrence or clinical efficacy were found.

Conclusions: FCSEMSs for treatment of symptomatic benign colonic strictures are safe and effective, despite a high rate of spontaneous migration.