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Published in: Digestive Diseases and Sciences 2/2008

01-02-2008 | Original Paper

Retrievable Esophageal Stents for Benign Indications

Authors: Robert F. Wong, Douglas G. Adler, Kristen Hilden, John C. Fang

Published in: Digestive Diseases and Sciences | Issue 2/2008

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Abstract

Until recently, esophageal stents have not been a realistic option for the management of benign disease owing to difficulty removing the stents and associated high complication rates. However, progress in esophageal stent design has led to the development of retrievable esophageal stents. Clinical experience has shown promise for the management of benign esophageal diseases with retrievable stents, including refractory strictures, esophageal leaks, fistula and perforations. They have been shown to be safe and effective, though stent migration remains a concern. This article reviews the current designs, indications, efficacy and complications of retrievable esophageal stents.
Literature
1.
go back to reference Baron TH (2001) Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med 344:1681–1687PubMedCrossRef Baron TH (2001) Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med 344:1681–1687PubMedCrossRef
2.
go back to reference Raju GS, Thompson C, Zwischenberger JB (2005) Emerging endoscopic options in the management of esophageal leaks (videos). Gastrointest Endosc 62:278–286PubMedCrossRef Raju GS, Thompson C, Zwischenberger JB (2005) Emerging endoscopic options in the management of esophageal leaks (videos). Gastrointest Endosc 62:278–286PubMedCrossRef
3.
go back to reference De Palma GD, Catanzano C (1998) Removable self-expanding metal stents: a pilot study for treatment of achalasia of the esophagus. Endoscopy 30:S95–S96PubMed De Palma GD, Catanzano C (1998) Removable self-expanding metal stents: a pilot study for treatment of achalasia of the esophagus. Endoscopy 30:S95–S96PubMed
4.
go back to reference Fiorini A, Fleischer D, Valero J, Israeli E, Wengrower D, Goldin E (2000) Self-expandable metal coil stents in the treatment of benign esophageal strictures refractory to conventional therapy: a case series. Gastrointest Endosc 52:259–262PubMedCrossRef Fiorini A, Fleischer D, Valero J, Israeli E, Wengrower D, Goldin E (2000) Self-expandable metal coil stents in the treatment of benign esophageal strictures refractory to conventional therapy: a case series. Gastrointest Endosc 52:259–262PubMedCrossRef
5.
go back to reference Lee JG, Hsu R, Leung JW (2000) Are self-expanding metal mesh stents useful in the treatment of benign esophageal stenoses and fistulas? An experience of four cases. Am J Gastroenterol 95:1920–1925PubMedCrossRef Lee JG, Hsu R, Leung JW (2000) Are self-expanding metal mesh stents useful in the treatment of benign esophageal stenoses and fistulas? An experience of four cases. Am J Gastroenterol 95:1920–1925PubMedCrossRef
6.
go back to reference Wadhwa RP, Kozarek RA, France RE, Brandabur JJ, Gluck M, Low DE, Traverso LW, Moonka R (2003) Use of self-expandable metallic stents in benign GI diseases. Gastrointest Endosc 58:207–212PubMedCrossRef Wadhwa RP, Kozarek RA, France RE, Brandabur JJ, Gluck M, Low DE, Traverso LW, Moonka R (2003) Use of self-expandable metallic stents in benign GI diseases. Gastrointest Endosc 58:207–212PubMedCrossRef
7.
go back to reference Ackroyd R, Watson DI, Devitt PG, Jamieson GG (2001) Expandable metallic stents should not be used in the treatment of benign esophageal strictures. J Gastroenterol Hepatol 16:484–487PubMedCrossRef Ackroyd R, Watson DI, Devitt PG, Jamieson GG (2001) Expandable metallic stents should not be used in the treatment of benign esophageal strictures. J Gastroenterol Hepatol 16:484–487PubMedCrossRef
8.
go back to reference Hramiec JE, O’Shea MA, Quinlan RM (1998) Expandable metallic esophageal stents in benign disease: a cause for concern. Surg Laparosc Endosc 8:40–43PubMedCrossRef Hramiec JE, O’Shea MA, Quinlan RM (1998) Expandable metallic esophageal stents in benign disease: a cause for concern. Surg Laparosc Endosc 8:40–43PubMedCrossRef
9.
go back to reference Seo YS, Park JJ, Kim BG, Kim JH, Kim JH, Kim CH, Kim JY, Byun KS, Bak YT (2006) Segmental amputation of esophagus with bronchial-wall rupture during removal of a stent for benign esophageal stricture. Gastrointest Endosc 64:141–143PubMedCrossRef Seo YS, Park JJ, Kim BG, Kim JH, Kim JH, Kim CH, Kim JY, Byun KS, Bak YT (2006) Segmental amputation of esophagus with bronchial-wall rupture during removal of a stent for benign esophageal stricture. Gastrointest Endosc 64:141–143PubMedCrossRef
11.
go back to reference Radecke K, Gerken G, Treichel U (2005) Impact of a self-expanding, plastic esophageal stent on various esophageal stenoses, fistulas, and leakages: a single-center experience in 39 patients. Gastrointest Endosc 61:812–818PubMedCrossRef Radecke K, Gerken G, Treichel U (2005) Impact of a self-expanding, plastic esophageal stent on various esophageal stenoses, fistulas, and leakages: a single-center experience in 39 patients. Gastrointest Endosc 61:812–818PubMedCrossRef
12.
go back to reference Garcia-Cano J (2005) Esophageal insertion of polyflex stents without fluoroscopy in peptic strictures. Endoscopy 37:400PubMedCrossRef Garcia-Cano J (2005) Esophageal insertion of polyflex stents without fluoroscopy in peptic strictures. Endoscopy 37:400PubMedCrossRef
13.
go back to reference Schubert D, Scheidbach H, Kuhn R, Wex C, Weiss G, Eder F, Lippert H, Pross M (2005) Endoscopic treatment of thoracic esophageal anastomotic leaks by using silicone-covered, self-expanding polyester stents. Gastrointest Endosc 61:891–896PubMedCrossRef Schubert D, Scheidbach H, Kuhn R, Wex C, Weiss G, Eder F, Lippert H, Pross M (2005) Endoscopic treatment of thoracic esophageal anastomotic leaks by using silicone-covered, self-expanding polyester stents. Gastrointest Endosc 61:891–896PubMedCrossRef
14.
go back to reference Evrard S, Le Moine O, Lazaraki G, Dormann A, El Nakadi I, Deviere J (2004) Self-expanding plastic stents for benign esophageal lesions. Gastrointest Endosc 60:894–900PubMedCrossRef Evrard S, Le Moine O, Lazaraki G, Dormann A, El Nakadi I, Deviere J (2004) Self-expanding plastic stents for benign esophageal lesions. Gastrointest Endosc 60:894–900PubMedCrossRef
15.
go back to reference Adler DG, Pleskow DK (2005) Closure of a benign tracheoesophageal fistula by using a coated, self-expanding plastic stent in a patient with a history of esophageal atresia. Gastrointest Endosc 61:765–768PubMedCrossRef Adler DG, Pleskow DK (2005) Closure of a benign tracheoesophageal fistula by using a coated, self-expanding plastic stent in a patient with a history of esophageal atresia. Gastrointest Endosc 61:765–768PubMedCrossRef
16.
go back to reference Bunch TJ, Nelson J, Foley T, Allison S, Crandall BG, Osborn JS, Weiss JP, Anderson JL, Nielsen P, Anderson L, Lappe DL, Day JD (2006) Temporary esophageal stenting allows healing of esophageal perforations following atrial fibrillation ablation procedures. J Cardiovasc Electrophysiol 17:435–439PubMedCrossRef Bunch TJ, Nelson J, Foley T, Allison S, Crandall BG, Osborn JS, Weiss JP, Anderson JL, Nielsen P, Anderson L, Lappe DL, Day JD (2006) Temporary esophageal stenting allows healing of esophageal perforations following atrial fibrillation ablation procedures. J Cardiovasc Electrophysiol 17:435–439PubMedCrossRef
17.
go back to reference Freeman RK, Ascioti AJ, Wozniak TC (2007) Postoperative esophageal leak management with the Polyflex esophageal stent. J Thorac Cardiovasc Surg 133:333–338PubMedCrossRef Freeman RK, Ascioti AJ, Wozniak TC (2007) Postoperative esophageal leak management with the Polyflex esophageal stent. J Thorac Cardiovasc Surg 133:333–338PubMedCrossRef
18.
go back to reference Gelbmann CM, Ratiu NL, Rath HC, Rogler G, Lock G, Scholmerich J, Kullmann F (2004) Use of self-expandable plastic stents for the treatment of esophageal perforations and symptomatic anastomotic leaks. Endoscopy 36:695–699PubMedCrossRef Gelbmann CM, Ratiu NL, Rath HC, Rogler G, Lock G, Scholmerich J, Kullmann F (2004) Use of self-expandable plastic stents for the treatment of esophageal perforations and symptomatic anastomotic leaks. Endoscopy 36:695–699PubMedCrossRef
19.
go back to reference Hunerbein M, Stroszczynski C, Moesta KT, Schlag PM (2004) Treatment of thoracic anastomotic leaks after esophagectomy with self-expanding plastic stents. Ann Surg 240:801–807PubMedCrossRef Hunerbein M, Stroszczynski C, Moesta KT, Schlag PM (2004) Treatment of thoracic anastomotic leaks after esophagectomy with self-expanding plastic stents. Ann Surg 240:801–807PubMedCrossRef
20.
go back to reference Langer FB, Wenzl E, Prager G, Salat A, Miholic J, Mang T, Zacherl J (2005) Management of postoperative esophageal leaks with the Polyflex self-expanding covered plastic stent. Ann Thorac Surg 79:398–403 discussion 404PubMedCrossRef Langer FB, Wenzl E, Prager G, Salat A, Miholic J, Mang T, Zacherl J (2005) Management of postoperative esophageal leaks with the Polyflex self-expanding covered plastic stent. Ann Thorac Surg 79:398–403 discussion 404PubMedCrossRef
21.
go back to reference Merrifield BF, Lautz D, Thompson CC (2006) Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach. Gastrointest Endosc 63:710–714PubMedCrossRef Merrifield BF, Lautz D, Thompson CC (2006) Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach. Gastrointest Endosc 63:710–714PubMedCrossRef
22.
go back to reference Ott C, Ratiu N, Endlicher E, Rath HC, Gelbmann CM, Scholmerich J, Kullmann F (2006) Self-expanding Polyflex plastic stents in esophageal disease: various indications, complications, and outcomes. Surg Endosc (in press) Ott C, Ratiu N, Endlicher E, Rath HC, Gelbmann CM, Scholmerich J, Kullmann F (2006) Self-expanding Polyflex plastic stents in esophageal disease: various indications, complications, and outcomes. Surg Endosc (in press)
23.
go back to reference Petruzziello L, Tringali A, Riccioni ME, Mutignani M, Margaritora S, Cesario A, Costamagna G (2003) Successful early treatment of Boerhaave’s syndrome by endoscopic placement of a temporary self-expandable plastic stent without fluoroscopy. Gastrointest Endosc 58:608–612PubMedCrossRef Petruzziello L, Tringali A, Riccioni ME, Mutignani M, Margaritora S, Cesario A, Costamagna G (2003) Successful early treatment of Boerhaave’s syndrome by endoscopic placement of a temporary self-expandable plastic stent without fluoroscopy. Gastrointest Endosc 58:608–612PubMedCrossRef
24.
go back to reference Tuncozgur B, Savas MC, Isik AF, Sarimehmetoglu A, Sanli M, Elbeyli L (2006) Removal of metallic stent by using polyflex stent in esophago-colic anastomotic stricture. Ann Thorac Surg 82:1913–1914PubMedCrossRef Tuncozgur B, Savas MC, Isik AF, Sarimehmetoglu A, Sanli M, Elbeyli L (2006) Removal of metallic stent by using polyflex stent in esophago-colic anastomotic stricture. Ann Thorac Surg 82:1913–1914PubMedCrossRef
25.
go back to reference Costamagna G, Shah SK, Tringali A, Mutignani M, Perri V, Riccioni ME (2003) Prospective evaluation of a new self-expanding plastic stent for inoperable esophageal strictures. Surg Endosc 17:891–895PubMedCrossRef Costamagna G, Shah SK, Tringali A, Mutignani M, Perri V, Riccioni ME (2003) Prospective evaluation of a new self-expanding plastic stent for inoperable esophageal strictures. Surg Endosc 17:891–895PubMedCrossRef
26.
go back to reference Pungpapong S, Raimondo M, Wallace MB, Woodward TA (2004) Problematic esophageal stricture: an emerging indication for self-expandable silicone stents. Gastrointest Endosc 60:842–845PubMedCrossRef Pungpapong S, Raimondo M, Wallace MB, Woodward TA (2004) Problematic esophageal stricture: an emerging indication for self-expandable silicone stents. Gastrointest Endosc 60:842–845PubMedCrossRef
27.
go back to reference Repici A, Conio M, De Angelis C, Battaglia E, Musso A, Pellicano R, Goss M, Venezia G, Rizzetto M, Saracco G (2004) Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures. Gastrointest Endosc 60:513–519PubMedCrossRef Repici A, Conio M, De Angelis C, Battaglia E, Musso A, Pellicano R, Goss M, Venezia G, Rizzetto M, Saracco G (2004) Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures. Gastrointest Endosc 60:513–519PubMedCrossRef
28.
go back to reference Siersema PD (2005) Treatment of esophageal perforations and anastomotic leaks: the endoscopist is stepping into the arena. Gastrointest Endosc 61:897–900PubMedCrossRef Siersema PD (2005) Treatment of esophageal perforations and anastomotic leaks: the endoscopist is stepping into the arena. Gastrointest Endosc 61:897–900PubMedCrossRef
29.
go back to reference Song HY, Park SI, Do YS, Yoon HK, Sung KB, Sohn KH, Min YI (1997) Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 203:131–136PubMed Song HY, Park SI, Do YS, Yoon HK, Sung KB, Sohn KH, Min YI (1997) Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 203:131–136PubMed
30.
go back to reference Song HY, Park SI, Jung HY, Kim SB, Kim JH, Huh SJ, Kim TH, Kim YK, Park S, Yoon HK, Sung KB, Min YI (1997) Benign and malignant esophageal strictures: treatment with a polyurethane-covered retrievable expandable metallic stent. Radiology 203:747–752PubMed Song HY, Park SI, Jung HY, Kim SB, Kim JH, Huh SJ, Kim TH, Kim YK, Park S, Yoon HK, Sung KB, Min YI (1997) Benign and malignant esophageal strictures: treatment with a polyurethane-covered retrievable expandable metallic stent. Radiology 203:747–752PubMed
31.
go back to reference Verschuur EM, Homs MY, Steyerberg EW, Haringsma J, Wahab PJ, Kuipers EJ, Siersema PD (2006) A new esophageal stent design (Niti-S stent) for the prevention of migration: a prospective study in 42 patients. Gastrointest Endosc 63:134–140PubMedCrossRef Verschuur EM, Homs MY, Steyerberg EW, Haringsma J, Wahab PJ, Kuipers EJ, Siersema PD (2006) A new esophageal stent design (Niti-S stent) for the prevention of migration: a prospective study in 42 patients. Gastrointest Endosc 63:134–140PubMedCrossRef
32.
go back to reference Song HY, Jung HY, Park SI, Kim SB, Lee DH, Kang SG, Il Min Y (2000) Covered retrievable expandable nitinol stents in patients with benign esophageal strictures: initial experience. Radiology 217:551–557PubMed Song HY, Jung HY, Park SI, Kim SB, Lee DH, Kang SG, Il Min Y (2000) Covered retrievable expandable nitinol stents in patients with benign esophageal strictures: initial experience. Radiology 217:551–557PubMed
33.
go back to reference Song HY, Lee DH, Seo TS, Kim SB, Jung HY, Kim JH, Park SI (2002) Retrievable covered nitinol stents: experiences in 108 patients with malignant esophageal strictures. J Vasc Interv Radiol 13:285–293PubMedCrossRef Song HY, Lee DH, Seo TS, Kim SB, Jung HY, Kim JH, Park SI (2002) Retrievable covered nitinol stents: experiences in 108 patients with malignant esophageal strictures. J Vasc Interv Radiol 13:285–293PubMedCrossRef
34.
go back to reference Yoon CJ, Shin JH, Song HY, Lim JO, Yoon HK, Sung KB (2004) Removal of retrievable esophageal and gastrointestinal stents: experience in 113 patients. AJR Am J Roentgenol 183:1437–1444PubMed Yoon CJ, Shin JH, Song HY, Lim JO, Yoon HK, Sung KB (2004) Removal of retrievable esophageal and gastrointestinal stents: experience in 113 patients. AJR Am J Roentgenol 183:1437–1444PubMed
35.
go back to reference Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ (2003) Temporary partially-covered metal stent insertion in benign esophageal stricture. World J Gastroenterol 9:2359–2361PubMed Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ (2003) Temporary partially-covered metal stent insertion in benign esophageal stricture. World J Gastroenterol 9:2359–2361PubMed
36.
go back to reference Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ (2003) Selection and evaluation of three interventional procedures for achalasia based on long-term follow-up. World J Gastroenterol 9:2370–2373PubMed Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ (2003) Selection and evaluation of three interventional procedures for achalasia based on long-term follow-up. World J Gastroenterol 9:2370–2373PubMed
37.
go back to reference Cheng YS, Li MH, Chen WX, Zhuang QX, Chen NW, Shang KZ (2003) Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion. World J Gastroenterol 9:2609–2611PubMed Cheng YS, Li MH, Chen WX, Zhuang QX, Chen NW, Shang KZ (2003) Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion. World J Gastroenterol 9:2609–2611PubMed
38.
go back to reference Zhang C, Yu JM, Fan GP, Shi CR, Yu SY, Wang HP, Ge L, Zhong WX (2005) The use of a retrievable self-expanding stent in treating childhood benign esophageal strictures. J Pediatr Surg 40:501–504PubMedCrossRef Zhang C, Yu JM, Fan GP, Shi CR, Yu SY, Wang HP, Ge L, Zhong WX (2005) The use of a retrievable self-expanding stent in treating childhood benign esophageal strictures. J Pediatr Surg 40:501–504PubMedCrossRef
39.
go back to reference Baron TH, Burgart LJ, Pochron NL (2006) An internally covered (lined) self-expanding metal esophageal stent: tissue response in a porcine model. Gastrointest Endosc 64:263–267PubMedCrossRef Baron TH, Burgart LJ, Pochron NL (2006) An internally covered (lined) self-expanding metal esophageal stent: tissue response in a porcine model. Gastrointest Endosc 64:263–267PubMedCrossRef
40.
go back to reference Schmid RA, Schob O, Hetzer F, Schlumpf R, Spiess M, Largiader F (1997) Experimental technique for (laparoscopic) bowel anastomosis: transient endoluminally stented anastomosis (TESA). Surg Laparosc Endosc 7:281–284PubMedCrossRef Schmid RA, Schob O, Hetzer F, Schlumpf R, Spiess M, Largiader F (1997) Experimental technique for (laparoscopic) bowel anastomosis: transient endoluminally stented anastomosis (TESA). Surg Laparosc Endosc 7:281–284PubMedCrossRef
41.
go back to reference Sewall GK, Warner T, Connor NP, Hartig GK (2003) Comparison of resobable poly-l-lactic acid-polyglycolic acid and internal Palmaz stents for the surgical correction of severe tracheomalacia. Ann Otol Rhinol Laryngol 112:515–521PubMed Sewall GK, Warner T, Connor NP, Hartig GK (2003) Comparison of resobable poly-l-lactic acid-polyglycolic acid and internal Palmaz stents for the surgical correction of severe tracheomalacia. Ann Otol Rhinol Laryngol 112:515–521PubMed
42.
go back to reference Fry SW, Fleischer DE (1997) Management of a refractory benign esophageal stricture with a new biodegradable stent. Gastrointest Endosc 45:179–182PubMedCrossRef Fry SW, Fleischer DE (1997) Management of a refractory benign esophageal stricture with a new biodegradable stent. Gastrointest Endosc 45:179–182PubMedCrossRef
43.
go back to reference Shin JH, Song HY, Kim JH, Kim SB, Lee GH, Park SI, Han YM, Kang W (2005) Comparison of temporary and permanent stent placement with concurrent radiation therapy in patients with esophageal carcinoma. J Vasc Interv Radiol 16:67–74 Shin JH, Song HY, Kim JH, Kim SB, Lee GH, Park SI, Han YM, Kang W (2005) Comparison of temporary and permanent stent placement with concurrent radiation therapy in patients with esophageal carcinoma. J Vasc Interv Radiol 16:67–74
Metadata
Title
Retrievable Esophageal Stents for Benign Indications
Authors
Robert F. Wong
Douglas G. Adler
Kristen Hilden
John C. Fang
Publication date
01-02-2008
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 2/2008
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-007-9883-4

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