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 1,  2, P. Bichard 3, J.-F. Demarquay 4, E. Ben-soussan 5, S. Lecleire 6, K. Barange 7, J.-M. Canard 8, H. Lamouliatte 9, E. Fontas 1, 10, M. Barthet11, T. Ponchon12, J.-C. Saurin12, ; on behalf of the Research Committee of the French Society of Digestive Endoscopy (SFED)
  •  1Faculty of Medicine, University of Nice Sophia-Antipolis, Nice, France
  •  2Department of Gastroenterology, University Hospital of Nice, Nice, France
  •  3University Hospital of Grenoble, Grenoble, France
  •  4Princess Grace Hospital, Principality of Monaco
  •  5Clinic of l’Alma, Paris, France
  •  6University Hospital of Rouen, Rouen, France
  •  7University Hospital of Toulouse, Toulouse, France
  •  8Clinic of Trocadéro, Paris, France
  •  9University Hospital of Bordeaux, Bordeaux, France
  • 10Department of Research, University Hospital of Nice, Nice, France
  • 11Department of Gastroenterology, Public Assistance Hospitals of Marseille, Marseille, France
  • 12Hospices civils of Lyon, Lyon, France
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.