Systematic review: the role of self‐expanding plastic stents for benign oesophageal strictures

Abstract

International audienceBACKGROUND: Treatment of refractory or recurrent benign oesophageal strictures is demanding, and surgery may be the only available option. The role of self-expanding plastic stents (SEPS) in the treatment of these strictures is still controversial, due to the conflicting results of various studies. METHODS: Pooled-data analysis of a systematic review of the literature. Clinical success was defined as no need for further endoscopic or surgical treatment after SEPS removal. RESULTS: Data of 10 studies with 130 treated patients were included. SEPS insertion was technically successful in 128 of 130 patients (98%, 95% CI = 96100%). Clinical success was achieved in 68 patients (52%, 95% CI = 4461%), and this was found to be lower in those with a cervical localization of the stricture (33% vs. 54%; p<0.05). Early (<4 weeks) migration of the stent was reported in 19 (24%, 95% CI = 1432%) cases, while post-insertion endoscopic reintervention was required in 25 (21%, 95% CI = 14-28%). Major clinical complications occurred in 12 patients (9%, 95% CI = 414%), resulting in death of one (0.8%) patient. CONCLUSIONS: Our pooled-data analysis showed a favorable risk/benefit ratio when SEPS are applied in patients with recurrent or refractory benign oesophageal strictures