PMID- 25110872
OWN - NLM
STAT- MEDLINE
DCOM- 20160302
LR  - 20220311
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 49
IP  - 6
DP  - 2015 Jul
TI  - Esophageal Stenting With Sutures: Time to Redefine Our Standards?
PG  - e57-60
LID - 10.1097/MCG.0000000000000198 [doi]
AB  - BACKGROUND AND STUDY AIMS: Migration is the most common complication of the fully 
      covered metallic self-expanding esophageal stent (FCSEMS). Recent studies have 
      demonstrated migration rates between 30% and 60%. The aim of this study was to 
      determine the effect of fixation of the FCSEMS by endoscopic suturing on 
      migration rate. PATIENT AND METHODS: Patients who underwent stent placement for 
      esophageal strictures and leaks over the last year were captured and reviewed 
      retrospectively. Group A, cases, were patients who underwent suture placement and 
      group B, controls, were patients who had stents without sutures. Basic 
      demographics, indications, and adverse events (AEs) were collected. Kaplan-Meier 
      analysis and Cox regression modeling were conducted to determine estimates and 
      predictors of stent migration in patients with and without suture placement. 
      RESULTS: Thirty-seven patients (18 males, 48.65%), mean age 57.2 years (+/-16.3 y), 
      were treated with esophageal FCSEMS. A total of 17 patients received sutures 
      (group A) and 20 patients received stents without sutures (group B). Stent 
      migration was noted in a total of 13 of the 37 patients (35%) [2 (11%) in group A 
      and 11 (55%) in group B]. Using Kaplan-Meier analysis and log-rank analysis, 
      fixation of the stent with suturing reduced the risk of migration (P=0.04). There 
      were no AEs directly related to suture placement. CONCLUSIONS: Anchoring of the 
      upper flare of the FCSEMS with endoscopic sutures is technically feasible and 
      significantly reduces stent migration rate when compared with no suturing, and is 
      a safe procedure with very low AEs rates.
FAU - Sharaiha, Reem Z
AU  - Sharaiha RZ
AD  - *Division of Gastroenterology and Hepatology, Weill Cornell Medical College 
      daggerDigestive and Liver Diseases, Columbia University Medical Center, New York, NY.
FAU - Kumta, Nikhil A
AU  - Kumta NA
FAU - Doukides, Theodore P
AU  - Doukides TP
FAU - Eguia, Vasco
AU  - Eguia V
FAU - Gonda, Tamas A
AU  - Gonda TA
FAU - Widmer, Jessica L
AU  - Widmer JL
FAU - Turner, Brian G
AU  - Turner BG
FAU - Poneros, John M
AU  - Poneros JM
FAU - Gaidhane, Monica
AU  - Gaidhane M
FAU - Kahaleh, Michel
AU  - Kahaleh M
FAU - Sethi, Amrita
AU  - Sethi A
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
SB  - IM
MH  - Adult
MH  - Aged
MH  - Esophageal Diseases/*surgery
MH  - Esophageal Stenosis/surgery
MH  - Esophagoscopy/methods
MH  - Female
MH  - Foreign-Body Migration/epidemiology/*prevention & control
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Self Expandable Metallic Stents/*adverse effects
MH  - Suture Techniques
MH  - *Sutures
EDAT- 2014/08/12 06:00
MHDA- 2016/03/05 06:00
CRDT- 2014/08/12 06:00
PHST- 2014/08/12 06:00 [entrez]
PHST- 2014/08/12 06:00 [pubmed]
PHST- 2016/03/05 06:00 [medline]
AID - 10.1097/MCG.0000000000000198 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 2015 Jul;49(6):e57-60. doi: 10.1097/MCG.0000000000000198.