Safety and Efficacy of Oesophageal Stents for Oesophageal Anastomotic Strictures; A Single Center Experience Over 10 Years

Aims Endoscopic bougie/balloon dilatation is considered as first line therapy for management of benign anastomotic oesophageal strictures post oesophagectomy, but repeated sessions are usually required. The management of recurrent/refractory anastomotic strictures is controversial. Repeated endoscopic sessions are additional physical and financial liability on patients, so early alternative methods, like early stent insertion needs investigation. The aim of this study is to evaluate efficacy and safety of stent insertion in post-oesophagectomy benign anastomotic strictures.

Methods A retrospective analysis was done for 28 patients, who underwent oesophageal stent placement for post-oesophagectomy anastomotic strictures at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan. The data was collected for a period of ten years from January, 2009 to January, 2019.

Results The efficacy of oesophageal stents included both technical and clinic success. The technical success rate was 96.4 %. The clinical success was measured in terms of dysphagia score at 4 weeks, 12 weeks and at 1 year post stenting. The clinical success was seen when dysphagia score at 4 weeks, 12 weeks and 1 year post stent were compared with baseline dysphagia score. The values were statistically significant as well. On comparing two groups, one who had refractory strictures (3 and more endoscopic procedure, prior to stent) with those who had non refractory strictures. Early stenting was associated with better dysphagia score at 4 weeks, 12 weeks and at 1 year, also overall less number of procedures and delayed recurrences as compared to refractory strictures.

Overall, serious complication rate was just 7.1 %, as two patients had fistula formation and had aspiration pneumonia or perforation. However non serious complication like stridor and migration were seen in 39 % patients.

Conclusions Stent insertion appears to be an effective and safe treatment for anastomotic strictures. They may be considered earlier in the course of treatment, before anastomotic strictures become refractory.

Citation: Bilal S, Muhammad Saeed S, Muhammad Siqqique Z et al. eP59 SAFETY AND EFFICACY OF OESOPHAGEAL STENTS FOR OESOPHAGEAL ANASTOMOTIC STRICTURES; A SINGLE CENTER EXPERIENCE OVER 10 YEARS. Endoscopy 2021; 53: S116.

Publication History

Article published online:
19 March 2021