Esophageal Stenting With Sutures
- 1 July 2015
- journal article
- research article
- Published by Wolters Kluwer Health in Journal of Clinical Gastroenterology
- Vol. 49 (6), e57-e60
- https://doi.org/10.1097/mcg.0000000000000198
Abstract
Migration is the most common complication of the fully covered metallic self-expanding esophageal stent (FCSEMS). Recent studies have demonstrated migration rates between 30% and 60%. The aim of this study was to determine the effect of fixation of the FCSEMS by endoscopic suturing on migration rate. Patients who underwent stent placement for esophageal strictures and leaks over the last year were captured and reviewed retrospectively. Group A, cases, were patients who underwent suture placement and group B, controls, were patients who had stents without sutures. Basic demographics, indications, and adverse events (AEs) were collected. Kaplan-Meier analysis and Cox regression modeling were conducted to determine estimates and predictors of stent migration in patients with and without suture placement. Thirty-seven patients (18 males, 48.65%), mean age 57.2 years (±16.3 y), were treated with esophageal FCSEMS. A total of 17 patients received sutures (group A) and 20 patients received stents without sutures (group B). Stent migration was noted in a total of 13 of the 37 patients (35%) [2 (11%) in group A and 11 (55%) in group B]. Using Kaplan-Meier analysis and log-rank analysis, fixation of the stent with suturing reduced the risk of migration (P=0.04). There were no AEs directly related to suture placement. Anchoring of the upper flare of the FCSEMS with endoscopic sutures is technically feasible and significantly reduces stent migration rate when compared with no suturing, and is a safe procedure with very low AEs rates.Keywords
This publication has 32 references indexed in Scilit:
- Endoscopic suture fixation of gastrointestinal stents: proof of biomechanical principles and early clinical experienceEndoscopy, 2012
- Efficacy and safety of a fully covered esophageal stent: a prospective studyGastrointestinal Endoscopy, 2012
- Fully covered removable nitinol self-expandable metal stents (SEMS) in malignant strictures of the esophagus: a multicenter analysisSurgical Endoscopy, 2011
- Esophageal Stenting in the Setting of MalignancyISRN Gastroenterology, 2011
- The role of clips in preventing migration of fully covered metallic esophageal stents: a pilot comparative studySurgical Endoscopy, 2011
- Self-expandable metal stents for the treatment of benign upper GI leaks and perforationsGastrointestinal Endoscopy, 2011
- Use of a fully covered self-expandable metal stent for the treatment of benign esophageal diseasesGastrointestinal Endoscopy, 2010
- Benign Strictures of the Esophagus and Gastric Outlet: Interventional ManagementKorean Journal of Radiology, 2010
- An internally covered (lined) self-expanding metal esophageal stent: tissue response in a porcine modelGastrointestinal Endoscopy, 2006
- Esophageal dilationGastrointestinal Endoscopy, 2006