EXPANDABLE METALLIC STENT PLACEMENT IN PATIENTS WITH BENIGN ESOPHAGEAL STRICTURES - RESULTS OF LONG-TERM FOLLOW-UP

PURPOSE: To evaluate the longterm effectiveness of expandable esophage al metallic stents in benign esophageal strictures. MATERIALS AND METH ODS: The authors performed long-term followup of 14 expandable metalli c stents in 12 patients (aged 16-72 years) with benign esophageal stri ctures. All 12 patients had initially undergone placement of one stent ; two patients received an additional stent because of recurrent dysph agia. RESULTS: No procedural complications occurred. Delayed complicat ions occurred in all patients. New strictures formed in six stents (fi ve patients), migration occurred in seven stents (six patients), and b oth migration and formation of new strictures occurred in one stent (o ne patient). New stricture formation caused recurrence of dysphagia an d necessitated further treatment. Three of four stents that migrated w ithin 2 months after placement but none of the four stents that migrat ed more than 2 months after placement caused recurrence of dysphagia. Six patients died of unrelated causes 6-20 months after stent placemen t. The remaining six patients are still alive 24-48 (mean, 35) months after stent placement. CONCLUSION: The long-term effectiveness of expa ndable metallic stents in benign esophageal strictures is not encourag ing because of the high delayed-complication rate. That the patients w ith migration showed improvement of dysphagia, however, may warrant fu rther investigation of temporary placement of a retrievable covered st ent.