Fully versus partially covered self-expandable metal stents in benign esophageal strictures
Abstract
Self-expandable plastic stents are currently recommended for refractory benign esophageal strictures but they show disappointing results in terms of migration and long-term efficacy. We report here our
experience in the management of benign esophageal strictures with partially covered (PCSEMS) and fully covered
self-expandable metal stents (FCSEMS). We performed a retrospective analysis of self-expandable metal stent
(SEMS) placements for benign esophageal strictures from 1998 to 2011 in Rouen University Hospital. Twenty-two
patients (15 men, 7 women) attempted 40 esophageal SEMS placements (17 PCSEMS, 23 FCSEMS) during this
period. All technical complications were migrations. Migration was noted after 3/17 PCSEMS (17.6%) and 4/23
FCSEMS placement (17.4%, P = ns). Clinical complications occurred after 6/17 PCSEMS and 2/23 FCSEMS
placements (35.3% vs. 8.7%, P = 0.053). PCSEMS caused two major complications (fistulae) whereas FCSEMS
did not cause any major complication (11.7% vs. 0%). Mean dysphagia score was significantly lower after
SEMS placement (1.68 vs. 3.08, P < 0.001) with similar results for PCSEMS and FCSEMS. Stent placement
resulted in long-term clinical success for 23.5% of PCSEMS and 34.7% of FCSEMS (P = 0.0505). FCSEMS
provide satisfying clinical success rate with an acceptable complication rate and they could constitute a relevant
therapeutic option in the management of benign esophageal strictures.