Self-Expandable Metallic Stent Therapy for a Gastrointestinal Benign Stricture

Han, Hae Won; Lee, In Seok; Park, Jae Myung; Oh, Jung Hwan; Cho, Yu Kyung; Kim, Sang Woo; Choi, Myung Gyu; Chung, In Sik

Abstract

BACKGROUND/AIMS
It is well known that self-expandable metallic stents are useful for the treatment of malignant strictures. Balloon and bougie dilation have received significant attention as a useful treatments for a gastriointestinal benign stricture, but the use of stents has some complications, including perforation and bleeding. We evaluated the clinical effectiveness and procedure- related complications of the use of self-expandable metallic stent therapy in gastrointestinal benign strictures. METHODS: We inserted self-expandable metallic stents in 11 patients with benign strictures during the period from January 2003 to May 2007. Eleven patients were included in this study (six males; mean age, 50.9 years). We observed clinical improvement, as well as complications and restenosis during follow-up. We defined "recurrence" as the return of symptoms. RESULTS: The causes of strictures were peptic ulcers (eight cases), corrosive esophagitis (two cases) and an anastomosis site stricture (one case). Three stents migrated within two weeks after placement. The mean length of time of a stent staying in a stricture was 16.1 days (3~35 days). After stent dilation, none of the patients had dysphagia to solid food or procedure- related complications. During a mean follow-up period of 12.8 months (3~35 months), the rate of restenosis was 36.4% (4/11 cases). All restenosis cases (two cases of peptic ulcer and two cases of corrosive esophagitis) occurred within three months after stent placement. CONCLUSIONS: We conclude that the use of self-expandable metallic stent therapy can be effective and safe for patients with gastrointestinal benign strictures. Restenosis (36.4%) occurred within three months. Future research on the management of gastrointestinal benign strictures is recommended.