Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

被引：16

作者：

Ngamruengphong, Saowanee ^{[1
]}

Sharaiha, Reem ^{[2
]}

Sethi, Amrita ^{[3
]}

Siddiqui, Ali ^{[4
]}

DiMaio, Christopher J. ^{[5
]}

Gonzalez, Susana ^{[5
]}

Rogart, Jason ^{[6
]}

Jagroop, Sophia ^{[7
]}

Widmer, Jessica ^{[7
]}

Im, Jennifer ^{[5
]}

Hasan, Raza Abbas ^{[4
]}

Laique, Sobia ^{[4
]}

Gonda, Tamas ^{[3
]}

Poneros, John ^{[3
]}

Desai, Amit ^{[2
]}

Wong, Katherine ^{[1
]}

Villgran, Vipin ^{[1
]}

Gutierrez, Olaya Brewer ^{[1
]}

Bukhari, Majidah ^{[1
]}

Chen, Yen-I ^{[1
]}

Hernaez, Ruben ^{[8
]}

Hanada, Yuri ^{[1
]}

Sanaei, Omid ^{[1
]}

Agarwal, Amol ^{[1
]}

Kalloo, Anthony N. ^{[1
]}

Kumbhari, Vivek ^{[1
]}

Singh, Vikesh ^{[1
]}

Khashab, Mouen A. ^{[1
]}

机构：

[1] Johns Hopkins Univ Hosp, Div Gastroenterol, Baltimore, MD 21287 USA

[2] Weill Cornell Med Coll, Div Gastroenterol & Hepatol, New York, NY USA

[3] Columbia Univ, Div Digest & Liver Dis, Med Ctr, New York, NY USA

[4] Thomas Jefferson Univ Hosp, Div Gastroenterol & Hepatol, Philadelphia, PA 19107 USA

[5] Icahn Sch Med Mt Sinai, Div Gastroenterol, New York, NY 10029 USA

[6] Capital Hlth Ctr Digest Hlth, Pennington, NJ USA

[7] North Shore Univ Hosp, Long Isl Jewish Med Ctr, Forest Hills, NY USA

[8] Baylor Coll Med, Dept Med, Sect Gastroenterol & Hepatol, Houston, TX 77030 USA

来源：

ENDOSCOPY INTERNATIONAL OPEN | 2018年 / 6卷 / 02期

关键词：

D O I：

10.1055/s-0043-125363

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and study aims Self-expandable metallic stents (SEMS) have been increasingly used in benign conditions (e.g. strictures, fistulas, leaks, and perforations). Fully covered SEMS (FSEMS) were introduced to avoid undesirable consequences of partially covered SEMS (PSEMS), but come with higher risk of stent migration. Endoscopic suturing (ES) for stent fixation has been shown to reduce migration of FSEMS.Our aim was to compare the outcomes of FSEMS with ES (FS/ES) versus PSEMS in patients with benign upper gastrointestinal conditions. Patients and methods We retrospectively identified all patients who underwent stent placement for benign gastrointestinal conditions at seven US tertiary-care centers. Patients were divided into two groups: FSEMS with ES (FS/ES group) and PSEMS (PSEMS group). Clinical outcomes between the two groups were compared. Results A total of 74 (FS/ES 46, PSEMS 28) patients were included. On multivariable analysis, there was no significant difference in rate of stent migration between FS/ES (43%) and PSEMS (15%) (adjusted odds ratio 0.56; 95% CI 0.15-2.00). Clinical success was similar [68% vs. 64%; P =0.81]. Rate of adverse events (AEs) was higher in PSEMS group [13 (46%) vs. 10 (21%); P =0.03). Difficult stent removal was higher in the PSEMS group (n=5;17%) vs. 0% in the FS/ES group; P =0.005. Conclusions The proportion of stent migration of FS/ES and PSEMS are similar. Rates of other stent-related AEs were higher in the PSEMS group. PSEMS was associated with tissue ingrowth or overgrowth leading to difficult stent removal, and secondary stricture formation. Thus, FSEMS with ES for stent fixation may be the preferred modality over PSEMS for the treatment of benign upper gastrointestinal conditions.

引用

页码：E217 / E223

页数：7

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