Document Detail

Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.
MedLine Citation:
PMID:  23261092     Owner:  NLM     Status:  MEDLINE    
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.
Emo E van Halsema; Louis M Wong Kee Song; Todd H Baron; Peter D Siersema; Frank P Vleggaar; Gregory G Ginsberg; Pari M Shah; David E Fleischer; Shiva K Ratuapli; Paul Fockens; Marcel G W Dijkgraaf; Giacomo Rando; Alessandro Repici; Jeanin E van Hooft
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  77     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-06-10     Revised Date:  2013-08-26    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-28     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Device Removal / adverse effects,  methods*
Equipment Safety
Esophageal Diseases / therapy*
Middle Aged
Retrospective Studies
Stents* / adverse effects
Comment In:
Gastrointest Endosc. 2013 Jul;78(1):192   [PMID:  23820417 ]
Gastrointest Endosc. 2013 Jul;78(1):192   [PMID:  23820418 ]

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