Year 2017 / Volume 109 / Number 7
Original
Endoscopically placed stents: a useful alternative for the management of refractory benign cervical esophageal stenosis

510-515

DOI: 10.17235/reed.2017.4795/2016

Óscar Nogales, Ana Clemente, Aránzazu Caballero-Marcos, Javier García-Lledó, Leticia Pérez-Carazo, Beatriz Merino, María López-Ibáñez, María Dolores Pérez Valderas, Rafael Bañares, Cecilia González-Asanza,

Abstract
Introduction: Benign esophageal strictures are relatively frequent and can severely affect the quality of life of a patient. Stenting has been proposed for the treatment of refractory cases. Lesions affecting the cervical esophagus are more difficult to treat, and the placement of stents in this location has traditionally been restricted due to potential adverse events. The aim of this study was to describe the efficacy and safety of endoscopic stenting in the management of refractory benign cervical esophageal strictures (RBCES) in a single-center cohort study. Methods: We analyzed 12 patients with RBCES (Kochman’s criteria) and severe dysphagia. We recorded previous endoscopic treatments, stricture characteristics and demographic data. The two types of stents used were fully covered self-expandable metallic stents (FCSEMS) and uncovered biodegradable stents (BDS). FCSEMS were removed eight weeks after placement, and BDS were followed-up until degradation. We assessed technical and clinical success, rate of stricture recurrence and adverse events. Results: The mean age of participants was 64 years (range 30-85). A total of 23 stents (13 FCSEMS and 10 BDS) were placed in 12 patients (median 1.92, range 1-4). The technical success rate was 96% (22/23 stents). Eight patients (66.6%) maintained adequate oral intake at the end of follow-up (median 33.3 months, range 3-84 months). Migration was recorded in 7/23 stents (30.4%) and epithelial hyperplasia in 4/23 stents (17.4%). No severe adverse events were noted. All patients complained of minor cervical pain after placement that was well controlled with mild analgesia. Conclusions: Endoscopic stent therapy seems to be effective and safe in the management of RBCES.
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References
1. de Wijkerslooth LR, Vleggaar FP, Siersema PD. Endoscopic management of difficult or recurrent esophageal strictures. Am J Gastroenterol 2011; 106(12):2080-91; quiz 2092
2. Didden P, Spaander MC, Bruno MJ et al. Esophageal stents in malignant and benign disorders. Curr Gastroenterol Rep. 2013;15(4):319
3. Raymondi R, Pereira-Lima JC, Valves A et al. Endoscopic dilation of benign esophageal strictures without fluoroscopy: experience of 2750 procedures. Hepatogastroenterology. 2008;55(85):1342-8
4. Kochman ML, McClave SA, Boyce HW. The refractory and the recurrent esophageal stricture: a definition. Gastrointest Endosc. 2005;62(3):474-5.
5. Repici A, Conio M, De Angelis C et al. Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures. Gastrointest Endosc. 2004;60(4):513-9.
6. Sharma P, Kozarek R, Practice Parameters Committee of American College of Gastroenterology Role of esophageal stents in benign and malignant diseases. Am J Gastroenterol. 2010;105(2):258-73; quiz 274
7. Siersema PD. Treatment options for esophageal strictures. Nat Clin Pract Gastroenterol Hepatol. 2008;5(3):142-52
8. Wadhwa RP, Kozarek RA, France RE et al. Use of self-expandable metallic stents in benign GI diseases. Gastrointest Endosc. 2003;58(2):207-12.
9. Repici A, Vleggaar FP, Hassan C et al. Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study. Gastrointest Endosc. 2010;72(5):927-34
10. Shim CS, Jung IS, Bhandari S et al. Management of malignant strictures of the cervical esophagus with a newly-designed self-expanding metal stent. Endoscopy. 2004;36(6):554-7.
11. Conio M, Caroli-Bosc F, Demarquay JF et al. Self-expanding metal stents in the palliation of neoplasms of the cervical esophagus. Hepatogastroenterology. 1999;46(25):272-7.
12. Profili S, Meloni GB, Feo CF et al. Self-expandable metal stents in the management of cervical oesophageal and/or hypopharyngeal strictures. Clin Radiol. 2002;57(11):1028-33
13. Gaspar LE, Winter K, Kocha WI et al. Swallowing function and weight change observed in a phase I/II study of external-beam radiation, brachytherapy and concurrent chemotherapy in localized cancer of the esophagus (RTOG 9207). Cancer J. 2001;7(5):388-94.
14. Choi EK, Song HY, Kim JW et al. Covered metallic stent placement in the management of cervical esophageal strictures. J Vasc Interv Radiol. 2007;18 (7):888-95.
15. Gallo A, Pagliuca G, de Vincentiis M et al. Endoscopic treatment of benign and malignant strictures of the cervical esophagus and hypopharynx. Ann Otol Rhinol Laryngol. 2012;121(2):104-9.
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Nogales Ó, Clemente A, Caballero-Marcos A, García-Lledó J, Pérez-Carazo L, Merino B, et all. Endoscopically placed stents: a useful alternative for the management of refractory benign cervical esophageal stenosis. 4795/2016


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Publication history

Received: 19/12/2016

Accepted: 13/03/2017

Online First: 08/06/2017

Published: 30/06/2017

Article revision time: 75 days

Article Online First time: 171 days

Article editing time: 193 days


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