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Surgical Endoscopy

, Volume 29, Issue 5, pp 1175–1178 | Cite as

Fully Covered Self-Expanding Metal Stents for Refractory Anastomotic Colorectal Strictures

  • Angelo CarusoEmail author
  • Rita Conigliaro
  • Raffaele Manta
  • Mauro Manno
  • Helga Bertani
  • Carmelo Barbera
  • Vincenzo Giorgio Mirante
  • Marzio Frazzoni
Article

Abstract

Background

Some patients with benign colorectal obstruction do not respond to endoscopic balloon dilation. Fully covered self-expandable metal stents (FCSEMSs) have several potential advantages over non-covered stents, including a higher likelihood of retrieval owing to limited local tissue reaction. However, the efficacy and safety of FCSEMSs in benign colorectal strictures have not yet been established.

Methods

Retrospective analysis of prospectively collected data concerning patients with post-surgical benign symptomatic anastomotic colorectal strictures, refractory to endoscopic dilation and in whom FCSEMSs had been placed at our center. Technical success was defined as successful stent placement and deployment at the stricture site. Early clinical success was defined as symptom relief persisting at least for 3 days. Follow-up was based on monthly clinical evaluation and quarterly endoscopic assessment. Endoscopic stent removal was planned on the basis of clinical or endoscopic assessment. Prolonged clinical success was defined as persistent symptom relief during follow-up.

Results

Technical and early clinical success were obtained in 16 of 16 (100 %) patients. The median follow-up was 21 months. Prolonged clinical success was achieved in 9/16 (56 %) cases. There was no major complication, including perforation and bleeding. Stent migration occurred in 3 (19 %) cases, in two of them associated with clinical failure. The median stent diameter was significantly higher in patients with successful than in those with unsuccessful clinical outcome (26 vs. 20 mm, P = 0.006). The clinical success rate was 1/6 (17 %) in patients who received a 20–22 mm stent and 8/10 (80 %) in those who received a 24–26 mm stent, respectively (P = 0.035).

Conclusions

FCSEMSs can represent effective and safe treatment for refractory anastomotic colorectal strictures. Large diameter stents are warranted for better results.

Keywords

Stent Benign Strictures 

Notes

Disclosures

Angelo Caruso, Rita Conigliaro, Raffaele Manta, Mauro Manno, Helga Bertani, Carmelo Barbera, Vincenzo Giorgio Mirante and Marzio Frazzoni have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Angelo Caruso
    • 1
    Email author
  • Rita Conigliaro
    • 1
  • Raffaele Manta
    • 1
  • Mauro Manno
    • 1
  • Helga Bertani
    • 1
  • Carmelo Barbera
    • 1
  • Vincenzo Giorgio Mirante
    • 1
  • Marzio Frazzoni
    • 2
  1. 1.Digestive Endoscopy UnitBaggiovara HospitalModenaItaly
  2. 2.Digestive Pathophysiology UnitBaggiovara HospitalModenaItaly

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