Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 10, 2016; 8(7): 338-343
Published online Apr 10, 2016. doi: 10.4253/wjge.v8.i7.338
Stent type used does not impact complication rate or placement time but can decrease treatment cost for benign and malignant esophageal lesions
Camille McGaw, Ahmad Alkaddour, Kenneth J Vega, Juan Carlos Munoz
Camille McGaw, Juan Carlos Munoz, Division of Gastroenterology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, United States
Ahmad Alkaddour, Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, United States
Kenneth J Vega, Division of Digestive Diseases and Nutrition, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, United States
Author contributions: McGaw C and Munoz JC designed the research and wrote the initial manuscript; McGaw C and Alkaddour A collected the data; Vega KJ, and Munoz JC reviewed the data for completeness and revised the manuscript for intellectual content; Vega KJ performed the statistical analysis; McGaw C, Alkaddour A, Vega KJ and Munoz JC approved the final version for submission.
Institutional review board statement: This study was approved by the University of Florida Health Science Center-Jacksonville Institutional Review Board (IRB).
Informed consent statement: This study was retrospective, using previously collected endoscopic and hospital data, which did not require a specific informed consent other than each patient agreeing to treatment with written consent at the time of procedure.
Conflict-of-interest statement: No conflict of interest exists for all authors.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kenneth J Vega, MD, Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1345, Oklahoma City, OK 73104, Unites States. kenneth-vega@ouhsc.edu
Telephone: +1-405-2715428 Fax: +1-405-2715803
Received: July 28, 2015
Peer-review started: August 1, 2015
First decision: September 16, 2015
Revised: October 27, 2015
Accepted: January 21, 2016
Article in press: January 22, 2016
Published online: April 10, 2016
Abstract

AIM: To evaluate if differences exist between self-expanding esophageal metal stents (SEMS) and self-expanding esophageal plastic stents (SEPS) when used for benign or malignant esophageal disorders with regard to safety, efficacy, clinical outcomes, placement ease and cost.

METHODS: A retrospective analysis was performed to evaluate outcome in patients having SEPS/SEMS placed for malignant or benign esophageal conditions from January 2005 to April 2012. Inclusion criteria was completed SEMS/SEPS placement. Outcomes assessed included technical success of and time required for stent placement, procedure-related complications, need for repeat intervention, hospital stay, mortality and costs.

RESULTS: Forty-three patients underwent stent placement for either benign/malignant esophageal disease during the study period. Thirty patients had SEMS (25 male, mean age 59.6 years old) and 13 patients had SEPS (10 male, mean age 61.7 years old). Placement outcome as well as complication rate (SEPS 23.1%, SEMS 25.2%) and in-hospital mortality (SEPS 7.7%, SEMS 6.7%) after placement did not differ between stent types. Migration was the most frequent complication reported occurring equally between types (SEPS 66.7%, SEMS 57.1%). SEPS was less costly than SEMS, decreasing institutional cost by $255/stent.

CONCLUSION: SEPS and SEMS have similar outcomes when used for benign or malignant esophageal conditions. However, SEPS use results in decreased costs without impacting care.

Keywords: Esophageal, Stent, Benign, Malignant, Complication, Placement, Cost

Core tip: Self-expanding esophageal metal stents (SEMS) are preferable to self-expanding esophageal plastic stents (SEPS) for treatment of malignant or benign esophageal conditions, due to decreased technical difficulties. Comparative studies between stent types evaluating differences between SEMS and SEPS for these conditions with regard to safety, efficacy, clinical outcomes, placement ease and cost are lacking. Retrospective analysis indicated placement outcome, complication rate, most frequent complication and in-hospital mortality after placement was equivalent between stent types. SEPS was less costly than SEMS. SEPS and SEMS have similar outcomes when used for malignant/benign esophageal conditions but SEPS results in decreased costs without impacting care.