Area riservata
Terapia endoscopica dell'ulcera gastrica sanguinante
Wiki Specialistica gastrologia
| A comparison of the temporary placement of 3different self-expanding stents for the treatment ofrefractory benign esophageal strictures: aprospective multicentre study |
| Scritto da BMC Gastroenterology |
 Background:Refractory benign esophageal strictures (RBESs) have been treated with the temporaryplacement of different self-expanding stents with conflicting results. We compared theclinical effectiveness of 3 types of stents: self-expanding plastic stents (SEPSs),biodegradable stents, and fully covered self-expanding metal stents (FCSEMSs), for thetreatment of RBES.Methods:This study prospectively evaluated 3 groups of 30 consecutive patients with RBESs whounderwent temporary placement of either SEPSs (12 weeks, n = 10), biodegradable stents(n = 10) or FCSEMSs (12 weeks, n = 10). Data were collected to analyze the technical successand clinical outcome of the stents as evaluated by recurrent dysphagia, complications andreinterventions.Results:Stent implantation was technically successful in all patients. Migration occurred in 11patients: 6 (60%) in the SEPS group, 2 (20%) in the biodegradable group and 3 (30%) in theFCSEMS group (P = 0.16). A total of 8/30 patients (26.6%) were dysphagia-free after the endof follow-up: 1 (10%) in the SEPS group, 3 (30%) in the biodegradable group and 4 (40%) inthe FCSEMS group (P = 0.27). More reinterventions were required in the SEPS group(n = 24) than in the biodegradable group (n = 13) or the FCSEMS group (n = 13) (P = 0.24).Multivariate analysis showed that stricture length was significantly associated with higherrecurrence rates after temporary stent placement (HR = 1.37; 95% CI = 1.08-1.75; P = 0.011).Conclusions:Temporary placement of a biodegradable stent or of a FCSEMS in patients with RBES maylead to long-term relief of dysphagia in 30 and 40% of patients, respectively. The use ofSEPSs seems least preferable, as they are associated with frequent stent migration, morereinterventions and few cases of long-term improvement. Additionally, longer strictures wereassociated with a higher risk of recurrence.Fonte: BMC Gastroenterology |