OAK BROOK, Ill. January 25, 2008 Researchers from Mayo Clinic in Rochester, Minnesota, recently examined the use of self-expanding plastic stents (SEPSs) in the treatment of benign esophageal disease and found that use of SEPSs resulted in frequent stent migration and few cases of long-term improvement. They concluded that further investigation is warranted to identify optimal patient populations and to guide future recommendations for the use of SEPSs. The study appears in the January issue of Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy.
Benign esophageal lesions such as strictures, perforations, and fistulae have a significant impact on patient well-being and are associated with the complications of malnutrition, pain, aspiration, respiratory decline, and death. In the past, the majority of refractory benign esophageal strictures were caused by chronic peptic irritation; however, with aggressive treatment of reflux disease, nonpeptic causes currently predominate. Esophageal stenting is a minimally invasive intervention that has been used as a treatment for expansion of stenoses and closure of perforations and fistulae. Self-expanding metal stents (SEMSs) are the current endoscopic standard for palliation of dysphagia resulting from malignant esophageal stenosis. SEMSs have also been used with variable success in the treatment of benign strictures.
Self-expanding plastic stents have been proposed for use in benign esophageal lesions because of their advantages over metallic stents, including lower cost, ease of placement and retrieval, and limited local tissue reaction while still providing alleviation of dysphagia. Previous reviews of the performance of SEPSs with limited numbers of patients have shown good success with resolution of benign stenosis and fistulae with few adverse effects.
In our study of self-expanding plastic stents, migration oc
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American Society for Gastrointestinal Endoscopy