Abstract
Self-expandable metal stent (SEMS) placement has been suggested as a therapeutic modality for treating benign colorectal strictures. Covered stents are generally used, given the concerns regarding the efficacy and safety of uncovered stents. Hence, few studies have evaluated the efficacy and safety of uncovered SEMSs (UCSEMSs) in patients with refractory benign colorectal anastomotic strictures. In this study, 12 patients with postoperative benign symptomatic anastomotic strictures refractory to pneumatic dilation (range, 2–9) and transient indwelling-covered SEMSs were treated using UCSEMS. All enrolled patients were men (mean age, 61 years). Stent placement was successful in all 12 patients, and early clinical success was achieved in 11 (92%) patients. Four patients (25%) showed successful clinical outcomes without further intervention, but eight patients (75%) were clinically unsuccessful, and showed stricture recurrence or functional obstructive symptoms. Three patients underwent surgery, and the remaining five patients required repeat stent procedures. Despite the high reobstruction rate, the median follow-up period after UCSEMS placement was 16.7 months, demonstrating that UCSEMS may be able to achieve medium-term symptom relief without any complications. Therefore, UCSEMS may be an alternative option in exceptional circumstances in carefully selected patients, where invasive surgical treatments, such as stoma diversion, are not an option, thereby improving patients’ quality of life.
Highlights
Self-expandable metal stent (SEMS) placement has been suggested as a therapeutic modality for treating benign colorectal strictures
Both fully covered SEMS (FCSEMS) and uncovered SEMS (UCSEMS) have advantages and disadvantages, FCSEMSs are primarily used for benign strictures because of the reduced local tissue response[16]
SEMSs used for benign colorectal diseases are associated with higher rates of stent-related complications, such as perforation, stent migration, recurrent obstruction, bleeding, and mucosal overgrowth than those used for malignant d iseases[11,12,13,17,28,29,30]
Summary
Self-expandable metal stent (SEMS) placement has been suggested as a therapeutic modality for treating benign colorectal strictures. Data regarding the use of SEMSs in patients with benign colorectal strictures have been obtained from heterogeneous studies, and the efficacy, safety, and long-term patency of SEMSs in these patients remains c ontroversial[11,12,16,17,18,19,20]. Both fully covered SEMS (FCSEMS) and uncovered SEMS (UCSEMS) have advantages and disadvantages, FCSEMSs are primarily used for benign strictures because of the reduced local tissue response[16]. To date, limited studies have examined the efficacy and safety of UCSEMS placement in patients with
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