Document Detail


Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study.
MedLine Citation:
PMID:  21034894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Benign esophageal strictures refractory to standard dilation therapy present a challenging problem. Temporary plastic and metal stents have been proposed with inconclusive results.
OBJECTIVE: To evaluate the efficacy and safety of a new biodegradable stent for the treatment of refractory benign esophageal strictures (RBESs).
DESIGN AND SETTING: Prospective study from 2 European endoscopy centers.
PATIENTS AND INTERVENTION: Twenty-one patients (11 men/10 women, mean age 60.2 ± 17.6 years) with RBESs defined according to the Kochman criteria treated by placement of a biodegradable stent (Ella stent).
MAIN OUTCOME MEASUREMENTS: Clinical and endoscopic follow-up was scheduled at 1, 2, 3, and 6 months and later only in case of dysphagia recurrence. Pre- and poststenting dysphagia status was graded according to a 5-point scale. Minor and major complication rates were prospectively assessed.
RESULTS: Stent insertion was technically successful in all of the patients. At 4 and 7 weeks, stent migration occurred in 2 patients (9.5%). At 3-month endoscopy, the stent appeared to be almost completely fragmented in all remaining patients. The median pre- and poststenting dysphagia scores were 3 (range 3-4) and 1 (range 0-2), respectively (P < .01), with a median follow-up of 53 weeks (range 25-88 weeks). In detail, 9 of 20 patients (45%) were dysphagia free at the end of the follow-up. No major complications occurred. Severe poststenting pain requiring analgesics developed in 3 patients, and minor bleeding was observed in 1 patient.
LIMITATIONS: Limited follow-up; nonrandomized study.
CONCLUSIONS: In this preliminary study, the biodegradable stent showed a favorable risk/benefit ratio, achieving complete relief of dysphagia in nearly 50% of RBES patients without the occurrence of major complications. The use of this stent may be a valuable alternative to repeat endoscopic dilation. Larger studies with longer follow-up are needed.
Authors:
Alessandro Repici; Frank P Vleggaar; Cesare Hassan; Petra G van Boeckel; Fabio Romeo; Nicola Pagano; Alberto Malesci; Peter D Siersema
Related Documents :
11593174 - The external approach for submucosal lesions of the larynx.
17113894 - Clinical utility of "blind placement" prostatic stent in patients with benign prostatic...
16376124 - Complicated acute type b dissections--an 8-years experience of endovascular stent-graft...
10604614 - Long-term results of endoscopic and percutaneous transhepatic treatment of benign bilia...
25420534 - The effects of armillarisin a on serum il-1β and il-4 and in treating ulcerative colitis.
2714094 - Factors influencing predilection and outcome in bacterial keratitis.
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  72     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2011-04-19     Revised Date:  2011-04-26    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  927-34     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy. alessandro.repici@humanitas.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Absorbable Implants*
Adult
Aged
Cohort Studies
Deglutition Disorders / etiology,  pathology,  prevention & control
Endoscopy, Gastrointestinal*
Equipment Design
Esophageal Stenosis / etiology,  pathology,  therapy*
Female
Humans
Male
Middle Aged
Polydioxanone*
Stents*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
PB-PG-1208-17025//Department of Health
Chemical
Reg. No./Substance:
31621-87-1/Polydioxanone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant dis...
Next Document:  Randomized comparison of 3 different-sized biopsy forceps for quality of sampling in Barrett's esoph...