Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. May 14, 2010; 16(18): 2260-2264
Published online May 14, 2010. doi: 10.3748/wjg.v16.i18.2260
Covered nitinol stents for the treatment of esophageal strictures and leaks
Davide Bona, Letizia Laface, Luigi Bonavina, Emmanuele Abate, Moshe Schaffer, Ippazio Ugenti, Stefano Siboni, Rosaria Carrinola
Davide Bona, Letizia Laface, Luigi Bonavina, Emmanuele Abate, Moshe Schaffer, Ippazio Ugenti, Stefano Siboni, Rosaria Carrinola, Department of Medical and Surgical Sciences, Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, 20100 Milano, Italy
Author contributions: Bona D and Bonavina L designed the study; Bona D placed the esophageal stents; Laface L, Abate E, Siboni S, Schaffer M, Ugenti I and Carrinola R participated in the data collection and statistical analysis; Abate E, Laface L and Bonavina L wrote the manuscript.
Correspondence to: Luigi Bonavina, Professor, Department of Medical and Surgical Sciences, Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, 20100 Milano, Italy. luigi.bonavina@unimi.it
Telephone: +39-2-52774621 Fax: +39-2-52774622
Received: December 21, 2009
Revised: January 31, 2010
Accepted: February 7, 2010
Published online: May 14, 2010
Abstract

AIM: To compare 2 different types of covered esophageal nitinol stents (Ultraflex and Choostent) in terms of efficacy, complications, and long-term outcome.

METHODS: A retrospective review of a consecutive series of 65 patients who underwent endoscopic placement of an Ultraflex stent (n = 33) or a Choostent (n = 32) from June 2001 to October 2009 was conducted.

RESULTS: Stent placement was successful in all patients without hospital mortality. No significant differences in patient discomfort and complications were observed between the Ultraflex stent and Choostent groups. The median follow-up time was 6 mo (inter-quartile range 3-16 mo). Endoscopic reintervention was required in 9 patients (14%) because of stent migration or food obstruction. No significant difference in the rate of reintervention between the 2 groups was observed (P = 0.8). The mean dysphagia score 1 mo after stent placement was 1.9 ± 0.3 for the Ultraflex stent and 2.1 ± 0.4 for the Choostent (P = 0.6). At 1-mo follow-up endoscopy, the cover membrane of the stent appeared to be damaged more frequently in the Choostent group (P = 0.34). Removal of the Choostent was possible up to 8 wk without difficulty.

CONCLUSION: Ultraflex and Choostent proved to be equally reliable for palliation of dysphagia and leaks. Removal of the Choostent was easy and safe under mild sedation.

Keywords: Dysphagia; Esophageal neoplasms; Endoscopy; Palliative care; Surgical anastomosis; Stricture; Neoadjuvant therapy; Self-expanding metal stents