PMID- 29404384 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220311 IS - 2364-3722 (Print) IS - 2196-9736 (Electronic) IS - 2196-9736 (Linking) VI - 6 IP - 2 DP - 2018 Feb TI - Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study. PG - E217-E223 LID - 10.1055/s-0043-125363 [doi] AB - BACKGROUND AND STUDY AIMS: Self-expandable metallic stents (SEMS) have been increasingly used in benign conditions (e. g. strictures, fistulas, leaks, and perforations). Fully covered SEMS (FSEMS) were introduced to avoid undesirable consequences of partially covered SEMS (PSEMS), but come with higher risk of stent migration. Endoscopic suturing (ES) for stent fixation has been shown to reduce migration of FSEMS. Our aim was to compare the outcomes of FSEMS with ES (FS/ES) versus PSEMS in patients with benign upper gastrointestinal conditions. PATIENTS AND METHODS: We retrospectively identified all patients who underwent stent placement for benign gastrointestinal conditions at seven US tertiary-care centers. Patients were divided into two groups: FSEMS with ES (FS/ES group) and PSEMS (PSEMS group). Clinical outcomes between the two groups were compared. RESULTS: A total of 74 (FS/ES 46, PSEMS 28) patients were included. On multivariable analysis, there was no significant difference in rate of stent migration between FS/ES (43 %) and PSEMS (15 %) (adjusted odds ratio 0.56; 95 % CI 0.15 - 2.00). Clinical success was similar [68 % vs. 64 %; P = 0.81]. Rate of adverse events (AEs) was higher in PSEMS group [13 (46 %) vs. 10 (21 %); P = 0.03). Difficult stent removal was higher in the PSEMS group (n = 5;17 %) vs. 0 % in the FS/ES group; P = 0.005. CONCLUSIONS: The proportion of stent migration of FS/ES and PSEMS are similar. Rates of other stent-related AEs were higher in the PSEMS group. PSEMS was associated with tissue ingrowth or overgrowth leading to difficult stent removal, and secondary stricture formation. Thus, FSEMS with ES for stent fixation may be the preferred modality over PSEMS for the treatment of benign upper gastrointestinal conditions. FAU - Ngamruengphong, Saowanee AU - Ngamruengphong S AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Sharaiha, Reem AU - Sharaiha R AD - Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, United States. FAU - Sethi, Amrita AU - Sethi A AD - Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, New York, United States. FAU - Siddiqui, Ali AU - Siddiqui A AD - Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. FAU - DiMaio, Christopher J AU - DiMaio CJ AD - Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, United States. FAU - Gonzalez, Susana AU - Gonzalez S AD - Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, United States. FAU - Rogart, Jason AU - Rogart J AD - Capital Health Center for Digestive Health, Pennington, New Jersey, United States. FAU - Jagroop, Sophia AU - Jagroop S AD - North Shore University Hospital/ Long Island Jewish Medical Center, Forest Hills, New York, United States. FAU - Widmer, Jessica AU - Widmer J AD - North Shore University Hospital/ Long Island Jewish Medical Center, Forest Hills, New York, United States. FAU - Im, Jennifer AU - Im J AD - Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, United States. FAU - Hasan, Raza Abbas AU - Hasan RA AD - Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. FAU - Laique, Sobia AU - Laique S AD - Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. FAU - Gonda, Tamas AU - Gonda T AD - Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, New York, United States. FAU - Poneros, John AU - Poneros J AD - Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, New York, United States. FAU - Desai, Amit AU - Desai A AD - Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, United States. FAU - Wong, Katherine AU - Wong K AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Villgran, Vipin AU - Villgran V AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Brewer Gutierrez, Olaya AU - Brewer Gutierrez O AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Bukhari, Majidah AU - Bukhari M AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Chen, Yen-I AU - Chen YI AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Hernaez, Ruben AU - Hernaez R AD - Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, United States. FAU - Hanada, Yuri AU - Hanada Y AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Sanaei, Omid AU - Sanaei O AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Agarwal, Amol AU - Agarwal A AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Kalloo, Anthony N AU - Kalloo AN AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Kumbhari, Vivek AU - Kumbhari V AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Singh, Vikesh AU - Singh V AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. FAU - Khashab, Mouen A AU - Khashab MA AD - Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States. LA - eng PT - Journal Article DEP - 20180202 PL - Germany TA - Endosc Int Open JT - Endoscopy international open JID - 101639919 PMC - PMC5797316 COIS- Competing interests Dr. Khashab is a consultant for Boston Scientific. Dr. Sethi acts as a consultant for Boston Scientific and Xlumera and has received travel expenses for unrelated meetings from Beacon Endoscope and Mauna Kea Technologies. Dr. Kalloo is a founding member, equity Holder and consultant for Apollo Endosurgery. Dr. Poneros acts as a consultant for Boston Scientific. Dr. Rogart acts as a consultant for Boston Scientific. Dr. DiMaio is a consultant and speaker for Boston Scientific. Dr. Singh is a consultant for Abbvie, D-Pharm, and Santarus. Dr. Kumbhari is a consultant for Boston Scientific, Apollo Endosurgery and Medtronic. EDAT- 2018/02/07 06:00 MHDA- 2018/02/07 06:01 PMCR- 2018/02/01 CRDT- 2018/02/07 06:00 PHST- 2017/09/26 00:00 [received] PHST- 2017/12/18 00:00 [accepted] PHST- 2018/02/07 06:00 [entrez] PHST- 2018/02/07 06:00 [pubmed] PHST- 2018/02/07 06:01 [medline] PHST- 2018/02/01 00:00 [pmc-release] AID - 10.1055/s-0043-125363 [doi] PST - ppublish SO - Endosc Int Open. 2018 Feb;6(2):E217-E223. doi: 10.1055/s-0043-125363. Epub 2018 Feb 2.