Safety and Efficacy of Endoscopically Secured Fully Covered Self-Expandable Metallic Stents (FCSEMS) for Post-Bariatric Complex Stenosis
BACKGROUND: The use of fully covered self-expandable metallic stents (FCSEMS) has opened the door to treat stenosis in the post-bariatric stomach. We hypothesized that endoscopically securing a FCSEMS would be technically feasible, effective, and safe for > 30-day dwell time.
OBJECTIVES: To assess the technical feasibility, clinical efficacy, and safety of endoscopically secured FCSEMS in the stomach for > 30 days.
METHODS: A retrospective review (September 2016 to April 2018) of consecutive patients who underwent FCSEMS suturing in the stomach at a single academic institution was reviewed. Technical success, stent dwell time, symptoms, and adverse events were recorded.
RESULTS: Fifteen patients (median age of 49 (31-70)) were included. Stents were inserted for gastrojejunal (GJ) stricture or gastric stenosis in 9/15 and 6/15 of patients, respectively. All procedures were technically successful (100%). Immediate and short-term clinical success (prior to stent removal) was 100% in patients who did not have stent migration. Stent migration was seen in 3 cases (20%) after a median dwell time of 211 days. However, 2/3 (66.6%) had not attended their scheduled removal. Recurrence of symptoms after stent removal was seen in 53.3% of patients with 40% undergoing repeat stenting. Median stent dwell was 117 (30-342) days. Sixty percent and 33% of patients had stent dwell of at least 90 and 180 days, respectively.
CONCLUSIONS: A FCSEMS, if secured, may be safe and effective for even > 90-day dwell time in the post-bariatric stomach and may result in long-term clinical success for GJ stricture after stent removal.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Obesity surgery - 29(2019), 11 vom: 28. Nov., Seite 3484-3492 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fayad, Lea [VerfasserIn] |
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| Links: |
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| Themen: |
Endoscopic suturing |
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| Anmerkungen: |
Date Completed 26.05.2020 Date Revised 10.01.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1007/s11695-019-04021-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM29868070X |
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| 245 | 1 | 0 | |a Safety and Efficacy of Endoscopically Secured Fully Covered Self-Expandable Metallic Stents (FCSEMS) for Post-Bariatric Complex Stenosis |
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| 500 | |a Date Revised 10.01.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The use of fully covered self-expandable metallic stents (FCSEMS) has opened the door to treat stenosis in the post-bariatric stomach. We hypothesized that endoscopically securing a FCSEMS would be technically feasible, effective, and safe for > 30-day dwell time | ||
| 520 | |a OBJECTIVES: To assess the technical feasibility, clinical efficacy, and safety of endoscopically secured FCSEMS in the stomach for > 30 days | ||
| 520 | |a METHODS: A retrospective review (September 2016 to April 2018) of consecutive patients who underwent FCSEMS suturing in the stomach at a single academic institution was reviewed. Technical success, stent dwell time, symptoms, and adverse events were recorded | ||
| 520 | |a RESULTS: Fifteen patients (median age of 49 (31-70)) were included. Stents were inserted for gastrojejunal (GJ) stricture or gastric stenosis in 9/15 and 6/15 of patients, respectively. All procedures were technically successful (100%). Immediate and short-term clinical success (prior to stent removal) was 100% in patients who did not have stent migration. Stent migration was seen in 3 cases (20%) after a median dwell time of 211 days. However, 2/3 (66.6%) had not attended their scheduled removal. Recurrence of symptoms after stent removal was seen in 53.3% of patients with 40% undergoing repeat stenting. Median stent dwell was 117 (30-342) days. Sixty percent and 33% of patients had stent dwell of at least 90 and 180 days, respectively | ||
| 520 | |a CONCLUSIONS: A FCSEMS, if secured, may be safe and effective for even > 90-day dwell time in the post-bariatric stomach and may result in long-term clinical success for GJ stricture after stent removal | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Endoscopic suturing | |
| 650 | 4 | |a Fully covered self-expandable metallic stents | |
| 650 | 4 | |a Laparoscopic sleeve gastrectomy | |
| 650 | 4 | |a Roux-en-Y gastric bypass | |
| 650 | 4 | |a Sleeve stenosis | |
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| 700 | 1 | |a Oleas, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Ichkhanian, Yervant |e verfasserin |4 aut | |
| 700 | 1 | |a Fayad, Georges E |e verfasserin |4 aut | |
| 700 | 1 | |a Ngamreungphong, Saowanee |e verfasserin |4 aut | |
| 700 | 1 | |a Schweitzer, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Oberbach, Andreas |e verfasserin |4 aut | |
| 700 | 1 | |a Kalloo, Anthony N |e verfasserin |4 aut | |
| 700 | 1 | |a Khashab, Mouen A |e verfasserin |4 aut | |
| 700 | 1 | |a Kumbhari, Vivek |e verfasserin |4 aut | |
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