Fully covered self-expanding metallic stent placement for benign refractory esophageal strictures.

Abstract

Treatment options for benign refractory esophageal stricture are limited. We retrospectively analyzed data of 11 patients who underwent fully covered self-expanding metallic stent (FC-SEMS) placement for refractory benign esophageal stricture at our institute. Refractory benign esophageal stricture was defined as inability to dilate a stricture to a diameter of 14mm after a minimum of five sessions at 2-week intervals or inability to maintain diameter of 14mm for at least 4weeks. Eleven patients with refractory benign esophageal stricture (corrosive-6, peptic-3, and post-sclerotherapy-2) underwent FC-SEMS placement. The stent was removed after 4-6weeks as per manufacturer's recommendation. Patients were followed up for 1year. Three patients with peptic strictures [length of stricture 2, 3, and 3cm] and two patients with post-sclerotherapy stricture [length 2 and 1.5cm] had complete response. Two of 6 patients with corrosive stricture (10cm, 12cm) developed recurrence of symptoms within 1month of stent removal, and two after 2months (8cm, 3cm). One patient with corrosive stricture (6cm) had recurrence after 6months, and responded to single session of dilatation. One patient with corrosive stricture was asymptomatic for last 12months. Four stents were migrated. Four patients developed severe retrosternal pain following stent placement, which was managed with analgesics. There were no serious adverse events after placement of stent and removal of stent. Fully covered SEMS is safe and effective for refractory benign non-corrosive esophageal strictures.