The role of biodegradable stents in the management of benign and malignant oesophageal strictures: A cohort study. Issue 6 (December 2016)

• Record Type: Journal Article
• Authors: McCain, Stephen; McCain, Scott; Quinn, Barry; Gray, Ronan; Morton, Joan; Rice, Paul
• Is Part Of: Surgeon. Volume 14:Issue 6(2016)
• Page Start: 322
• Page End: 326
• Publication Date: 2016-12
• Subjects: Oesophageal stricture -- Benign stricture -- Malignant stricture -- Biodegradable stent; Surgery -- Periodicals; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617
• DOI: 10.1016/j.surge.2015.01.002
• Languages: English
• ISSNs: 1479-666X

Abstract

Abstract: Background: Oesophageal strictures can be caused by benign or malignant processes. Up to 10% of patients with a benign stricture are refractory to pneumatic dilatation and may benefit from biodegradable stent (BD) insertion. Biodegradable stents also have a role in malignant oesophageal strictures to facilitate enteral nutrition while staging or neo-adjuvant treatment is completed. The aim of this study was to review the safety and efficacy of BD stents in the management of benign or malignant oesophageal strictures. Methods: A single centre retrospective cohort study was performed. Dysphagia was graded before and after stenting using a validated score. All patients were followed up for at least 30 days and all adverse events were recorded. Results: Twenty eight stents were inserted in 20 patients; 11 for malignant and 17 for benign disease. One further attempted stenting was impossible due to a high benign stricture. There were no perforations and the 30-day mortality rate was zero. Mean dysphagia scores improved from 2.65 to 1.00 (p value <0.001) in benign disease and from 3.27 to 1.36 (p value <0.001) in patients with malignant disease. Surgical resection was not compromised following stent insertion in the malignant group. Conclusions: Biodegradable stent insertion is a safe and efficacious adjunct in the treatment of benign and malignant oesophageal strictures. In malignant disease, BD stent insertion can maintain enteral nutrition while staging or neo-adjuvant therapy is completed without adversely impacting on surgical resection.