PMID- 36316581 OWN - NLM STAT- MEDLINE DCOM- 20230320 LR - 20230411 IS - 1432-2218 (Electronic) IS - 0930-2794 (Linking) VI - 37 IP - 3 DP - 2023 Mar TI - Lumen-apposing metal stents for the treatment of benign gastrointestinal tract strictures: a single-center experience and proposed treatment algorithm. PG - 2133-2142 LID - 10.1007/s00464-022-09715-8 [doi] AB - BACKGROUND: Lumen-apposing metal stents (LAMS) are an alternative therapeutic option for benign gastrointestinal (GI) tract strictures. Our study aimed to evaluate the safety and efficacy of LAMS for the management of benign GI strictures. METHODS: Consecutive patients who underwent a LAMS placement for benign luminal GI strictures at a tertiary care center between January 2014 and July 2021 were reviewed. Primary outcomes included technical success, early clinical success, and adverse events (AEs). Other outcomes included rates of stent migration and re-intervention after LAMS removal. RESULTS: One hundred and nine patients who underwent 128 LAMS placements (67.9% female, mean age of 54.3 +/- 14.2 years) were included, and 70.6% of the patients had failed prior endoscopic treatments. The majority of strictures (83.5%) were anastomotic, and the most common stricture site was the gastrojejunal anastomosis (65.9%). Technical success was achieved in 100% of procedures, while early clinical success was achieved in 98.4%. The overall stent-related AE rate was 25%. The migration rate was 27.3% (35/128). Of these, five stents were successfully repositioned endoscopically. The median stent dwell time was 119 days [interquartile range (IQR) 68-189 days], and the median follow-up duration was 668.5 days [IQR: 285.5-1441.5 days]. The re-intervention rate after LAMS removal was 58.3%. CONCLUSIONS: LAMS is an effective therapeutic option for benign GI strictures, offering high technical and early clinical success. However, the re-intervention rate after LAMS removal was high. In select cases, using LAMS placement as destination therapy with close surveillance is a reasonable option. CI - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Mahmoud, Tala AU - Mahmoud T AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Beran, Azizullah AU - Beran A AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. AD - Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, USA. FAU - Bazerbachi, Fateh AU - Bazerbachi F AD - Interventional Endoscopy Program, CentraCare Digestive Center, St. Cloud Hospital, St. Cloud, MN, USA. FAU - Matar, Reem AU - Matar R AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Jaruvongvanich, Veeravich AU - Jaruvongvanich V AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Razzak, Farah Abdul AU - Razzak FA AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Abboud, Donna Maria AU - Abboud DM AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Vargas, Eric J AU - Vargas EJ AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Martin, John A AU - Martin JA AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Kellogg, Todd A AU - Kellogg TA AD - Department of Surgery, Mayo Clinic, Rochester, MN, USA. FAU - Ghanem, Omar M AU - Ghanem OM AD - Department of Surgery, Mayo Clinic, Rochester, MN, USA. FAU - Petersen, Bret T AU - Petersen BT AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Levy, Michael J AU - Levy MJ AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Law, Ryan J AU - Law RJ AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Chandrasekhara, Vinay AU - Chandrasekhara V AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Storm, Andrew C AU - Storm AC AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Wong Kee Song, Louis M AU - Wong Kee Song LM AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Buttar, Navtej S AU - Buttar NS AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. FAU - Abu Dayyeh, Barham K AU - Abu Dayyeh BK AUID- ORCID: 0000-0001-8084-7225 AD - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. AbuDayyeh.Barham@mayo.edu. LA - eng PT - Journal Article DEP - 20221031 PL - Germany TA - Surg Endosc JT - Surgical endoscopy JID - 8806653 SB - IM MH - Humans MH - Female MH - Adult MH - Middle Aged MH - Aged MH - Male MH - Constriction, Pathologic/etiology MH - *Gastrointestinal Diseases/surgery MH - Stents/adverse effects MH - Endoscopy MH - Treatment Outcome OTO - NOTNLM OT - Benign gastrointestinal strictures OT - Lumen-apposing metal stents OT - Stent EDAT- 2022/11/02 06:00 MHDA- 2023/03/21 06:00 CRDT- 2022/11/01 00:39 PHST- 2022/04/16 00:00 [received] PHST- 2022/10/11 00:00 [accepted] PHST- 2022/11/02 06:00 [pubmed] PHST- 2023/03/21 06:00 [medline] PHST- 2022/11/01 00:39 [entrez] AID - 10.1007/s00464-022-09715-8 [pii] AID - 10.1007/s00464-022-09715-8 [doi] PST - ppublish SO - Surg Endosc. 2023 Mar;37(3):2133-2142. doi: 10.1007/s00464-022-09715-8. Epub 2022 Oct 31.