摘要
AIM: To analyze the outcomes of self-expandable stent placement for benign esophageal strictures and benign esophageal leaks in the literature.METHODS: The Pub Med, Embase and Cochrane databases were searched for relevant articles published between January 2000 and July 2014. Eight prospective studies were identified that analyzed the outcomes of stent placement for refractory benign esophageal strictures. The outcomes of stent placement for benign esophageal leaks, perforations and fistulae were extracted from 20 retrospective studies that were published after the inclusion period of a recent systematic review. Data were pooled and analyzed using descriptive statistics.RESULTS: Fully covered self-expandable metal stents(FC SEMS)(n = 85), biodegradable(BD) stents(n = 77) and self-expandable plastic stents(SEPS)(n = 70) were inserted in 232 patients with refractory benign esophageal strictures. The overall clinical success rate was 24.2% and according to stent type 14.1% for FC SEMS, 32.9% for BD stents and 27.1% for SEPS. Stent migration occurred in 24.6% of cases. The overall complication rate was 31.0%, including major(17.7%) and minor(13.4%) complications. A total of 643 patients were treated with self-expandable stents mainly for postsurgical leaks(64.5%), iatrogenic perforations(19.6%), Boerhaave's syndrome(7.8%) and fistulae(3.7%). FC SEMS and partially covered SEMS were used in the majority of patients. Successful closure of the defect was achieved in 76.8% of patients and according to etiology in 81.4% for postsurgical leaks, 86.0% for perforations and 64.7% for fistulae. The pooled stent migration rate was 16.5%. Stent-related complications occurred in 13.4% of patients, including major(7.8%) and minor(5.5%) complications.CONCLUSION: The outcomes of stent placement for refractory benign esophageal strictures were poor. However, randomized trials are needed to put this into perspective. The evidence on successful stent placement for benign esophageal leaks, perforationsand fistulae is promising.
AIM： To analyze the outcomes of self-expandable stentplacement for benign esophageal strictures and benignesophageal leaks in the literature.METHODS： The PubMed, Embase and Cochranedatabases were searched for relevant articles publishedbetween January 2000 and July 2014. Eight prospectivestudies were identified that analyzed the outcomesof stent placement for refractory benign esophagealstrictures. The outcomes of stent placement forbenign esophageal leaks, perforations and fistulaewere extracted from 20 retrospective studies thatwere published after the inclusion period of a recentsystematic review. Data were pooled and analyzedusing descriptive statistics.RESULTS： Fully covered self-expandable metal stents（FC SEMS） （n = 85）, biodegradable （BD） stents （n =77） and self-expandable plastic stents （SEPS） （n = 70）were inserted in 232 patients with refractory benignesophageal strictures. The overall clinical success ratewas 24.2% and according to stent type 14.1% forFC SEMS, 32.9% for BD stents and 27.1% for SEPS.Stent migration occurred in 24.6% of cases. Theoverall complication rate was 31.0%, including major（17.7%） and minor （13.4%） complications. A total of643 patients were treated with self-expandable stentsmainly for postsurgical leaks （64.5%）, iatrogenicperforations （19.6%）, Boerhaave＇s syndrome （7.8%）and fistulae （3.7%）. FC SEMS and partially coveredSEMS were used in the majority of patients. Successfulclosure of the defect was achieved in 76.8% ofpatients and according to etiology in 81.4% forpostsurgical leaks, 86.0% for perforations and 64.7%for fistulae. The pooled stent migration rate was16.5%. Stent-related complications occurred in 13.4%of patients, including major （7.8%） and minor （5.5%）complications.CONCLUSION： The outcomes of stent placementfor refractory benign esophageal strictures were poor.However, randomized trials are needed to put thisinto perspective. The evidence on successful stentplacement for benign esophageal leaks, perforations van Halsema EE et al . Stents for benign esophageal diseases and fistulae is promising.
