van Halsema EE, Wong Kee Song LM, Baron TH, Siersema PD, Vleggaar FP, Ginsberg GG, Shah PM, Fleischer DE, Ratuapli SK, Fockens P, Dijkgraaf MGW, Rando G, Repici A, van Hooft JE. Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.
Gastrointest Endosc 2013;
77:18-28. [PMID:
23261092 DOI:
10.1016/j.gie.2012.09.001]
[Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 09/02/2012] [Indexed: 02/08/2023]
Abstract
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.
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