Background
Temporary placement of self-expandable stents has been increasingly used for the management
of benign esophageal diseases.
Objective
To evaluate the safety of endoscopic removal of esophageal self-expandable stents
placed for the treatment of benign esophageal diseases.
Design
Multicenter retrospective study.
Setting
Six tertiary care centers in the United States and Europe.
Patients
A total of 214 patients with benign esophageal diseases undergoing endoscopic stent
removal.
Intervention
Endoscopic stent removal.
Main Outcome Measurements
Endoscopic techniques for stent removal, time to stent removal, and adverse events
related to stent removal.
Results
A total of 214 patients underwent a total of 329 stent extractions. Stents were mainly
placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents,
52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially
covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic
stents. A total of 35 (10.6%) procedure-related adverse events were reported, including
7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs
(P < .001) was a risk factor for adverse events during stent removal. Favorable factors
for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194).
Limitations
Retrospective analysis, only tertiary care centers.
Conclusions
With an acceptable major adverse event rate of 2.1%, esophageal stent removal in the
setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were
more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse
events caused by stent removal were not time dependent.
Abbreviations:
CI (confidence interval), FCSEMS (fully covered self-expandable metal stent), IQR (interquartile range), OR (odds ratio), PCSEMS (partially covered self-expandable metal stent), SEMS (self-expandable metal stent), SEPS (self-expandable plastic stent)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
September 2,
2012
Received:
June 23,
2012
Footnotes
DISCLOSURE: The following author disclosed financial relationships relevant to this publication: Dr Baron: travel support from Boston Scientific; on the advisory board of Merit Endotek. The other authors disclosed no financial relationships relevant to this publication.
See CME section; p. 108.
If you would like to chat with an author of this article, you may contact Dr van Hooft at [email protected]
Identification
Copyright
© 2013 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Removing in situ esophageal stentsGastrointestinal EndoscopyVol. 78Issue 1
- PreviewWe read with interest the article “Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.”1 We believe there are some considerations that should be made regarding 2 subsets of patients who should have not been included in this study and that possibly explain the unusually extraordinary results reported by the authors. In the first place, patients needing an inner stent for the “stent in stent” retrieving technique should not have been accounted for, because in this technique the inner stent is not in contact with the esophageal wall.
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