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Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.

AbstractBACKGROUND:
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.
AuthorsEmo 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
JournalGastrointestinal endoscopy (Gastrointest Endosc) Vol. 77 Issue 1 Pg. 18-28 (Jan 2013) ISSN: 1097-6779 [Electronic] United States
PMID23261092 (Publication Type: Journal Article, Multicenter Study)
CopyrightCopyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Topics
  • Device Removal (adverse effects, methods)
  • Equipment Safety
  • Esophageal Diseases (therapy)
  • Esophagoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents (adverse effects)

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