Fully versus partially covered self-expandable metal stents in benign esophageal strictures

A. Gangloff (1) , S. Lecleire (1) , A. Di Fiore (1) , E. Huet (2, 3, 4, 5) , I. Iwanicki-Caron (1) , M. Antonietti (1) , P. Michel (1)

1 Service d'Hépato-Gastroentérologie [CHU Rouen]
2 Service de chirurgie digestive [CHU Rouen]
3 ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau
4 IRIB - Institute for Research and Innovation in Biomedicine
5 UNIROUEN UFR Santé - UNIROUEN - UFR Santé

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.

Keywords: benign esophageal stricture; endoscopy; fully covered self-expandable metal stent; partially covered self-expandable metal stent.

Domains: Life Sciences [q-bio]; Human health and pathology; Hépatology and Gastroenterology

A. Gangloff, S. Lecleire, A. Di Fiore, E. Huet, I. Iwanicki-Caron, et al.. Fully versus partially covered self-expandable metal stents in benign esophageal strictures. Diseases of the Esophagus, 2015, 28 (7), pp.678-683. ⟨10.1111/dote.12260⟩. ⟨hal-02372047⟩