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DOI: 10.1055/s-0040-1704661
COMBINED THERAPY IN THE MANAGEMENT OF COMPLEX BENIGN ESOPHAGEAL STRICTURES: FULLY COVERED SELF-EXPANDABLE METALLIC STENTS AND BIODEGRADABLE STENTS
Publication History
Publication Date:
23 April 2020 (online)
Aims To evaluate the safety and efficacy of fully covered self-expandable esophageal metallic stent (FCSEMS) and biodegradable stent in the management of complex esophageal strictures and postsurgical stenosis.
Methods Prospectively data from consecutive patients (May 2016 to April 2019) in a single-tertiary center from Ecuador. Safety was defined in terms on adverse events occurrence in accordance to the ASGE Lexicon. Efficacy was defined as an Atkinson Dysphagia Score (ADSS ≤3) or the ability to swallow liquid content after stent placement.
Results 36 patients were treated with esophageal stenting during the study period; however, 11 patients met inclusion criteria and were included for analysis, with a median age of 12 years (range: 5-63), 45% were female. Stents were placed for the management of complex caustic strictures (7/11) and post-surgical stenosis (4/11). The median number of stents placed was 1 (range: 1-5). All patients received a FCSEMS as first stenting therapy. Recurrence of symptoms after stent removal occurred in 5/11 (45%) patient, undergoing a second repeat stenting (3/5 with biodegradable stent and 2/5 with FCSEMS), 4 patients required a third stenting session (3/4 with biodegradable stent and ¼ with FCSEMS), 4 patients a fourth stenting session (2/4 biodegradable stent and 2/4 with FCSEMS) and 3 patients a fifth stenting session (1/3 biodegradable stent and 2/3 with a FCSEMS). The median initial ADSS was 3 (range 2-4). Efficacy: 9/11 (82%) achieved an ADSS ≤2 during follow-up with a median 1 ADSS after therapy (range: 0-4). Any patient experiences an adverse severe event; however, 5/11 (45%) patients experience stent migration treated with stent removal. The median days of follow-up was 505 days (range: 68-1056).
Conclusions Combined therapy with self-expandable esophageal metallic stent and biodegradable esophageal stents is a safe and effective therapy for the management of dysphagia in patient with complex benign esophageal strictures and postsurgical stenosis.