The use of retrievable fully covered self-expanding metal stent in refractory postoperative restenosis of benign esophageal stricture in children

J Pediatr Surg. 2013 Nov;48(11):2235-40. doi: 10.1016/j.jpedsurg.2013.06.005.

Abstract

Purpose: This study analyzes the efficacy and safety of a retrievable, fully covered self-expanding metal stent (cSEMS) in the treatment of refractory benign esophageal restenosis in children.

Methods: This is a retrospective analysis of the application of a newly designed cSEMS in treating refractory benign postoperative restenosis in five children with ages ranging from 16 months to 8 years. Efficacy and safety were evaluated during the follow-up period.

Results: cSEMS with or without an antireflux valve at the distal end were successfully placed and removed in five children. These five patients were followed up for 4-12 months after stent removal. Among the five patients, ulcerative stricture was observed in two patients because of reflux esophagitis, while three patients showed no signs of stricture recurrence. Stent migration was observed in three patients, two of which required the stent to be reset. The narrow esophagus was successfully expended to a diameter of 12-13 mm. Besides the observation of mild granulation tissue growth in one case, no severe complications were observed during surgery and after stent placement.

Conclusion: Our study suggests that a retrievable, fully covered SEMS is safe and partially effective for treating refractory benign postoperative esophageal restenosis in children during short-term observation.

Keywords: Congenital esophageal stricture; Covered retrieval self-expanding stent.

Publication types

  • Evaluation Study

MeSH terms

  • Anastomosis, Surgical
  • Child
  • Child, Preschool
  • Deglutition Disorders / etiology
  • Dilatation / instrumentation*
  • Equipment Design
  • Esophageal Atresia / surgery
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / surgery
  • Esophageal Stenosis / therapy*
  • Esophagitis, Peptic / complications
  • Follow-Up Studies
  • Foreign-Body Migration / etiology
  • Foreign-Body Reaction / etiology
  • Foreign-Body Reaction / pathology
  • Granulation Tissue / pathology
  • Humans
  • Infant
  • Male
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Postoperative Complications / therapy*
  • Recurrence
  • Retrospective Studies
  • Silicone Elastomers
  • Stainless Steel
  • Stents* / adverse effects
  • Stomach

Substances

  • Silicone Elastomers
  • Stainless Steel