Prospective trial of biodegradable stents for refractory benign esophageal strictures after curative treatment of esophageal cancer
| Autor: | Akihiro Sato, Masaki Tanaka, Hiroyuki Morimoto, Hiromi Hasegawa, Tomonori Yano, Takahiro Horimatsu, Kazuhiro Kaneko, Kayo Toyosaki, Hiroyuki Ono, Yusuke Yoda, Shogo Nomura, Satoru Nonaka |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Endoscope Endoscopic Mucosal Resection Esophageal Neoplasms medicine.medical_treatment 03 medical and health sciences Esophageal Fistula 0302 clinical medicine Postoperative Complications Refractory Absorbable Implants medicine Clinical endpoint Humans Radiology Nuclear Medicine and imaging Prospective Studies Adverse effect Aged Aged 80 and over business.industry Gastroenterology Chemoradiotherapy Esophageal cancer Middle Aged medicine.disease Surgery Clinical trial Esophagectomy Treatment Outcome 030220 oncology & carcinogenesis Esophageal Stenosis 030211 gastroenterology & hepatology Female Stents Bronchial Fistula business Deglutition Disorders |
| Zdroj: | Gastrointestinal endoscopy. 86(3) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims Biodegradable stents are reportedly effective for refractory benign esophageal strictures; however, little is known about their use in patients with refractory stricture after endoscopic submucosal dissection (ESD) or chemoradiotherapy (CRT) for esophageal cancer. This study aimed to evaluate the effectiveness of biodegradable stents for these patients. Methods Patients with refractory benign esophageal stricture with a dysphagia score (DS) of 2 or worse and for whom the passage of a standard size endoscope was not possible were eligible. The primary endpoint was the proportion of those who improved their DSs (% DS improved) at 12 weeks after stent placement, and the secondary endpoints were the proportion of those who improved their DSs at 24 weeks, dysphagia-free survival (DFS), and adverse events. Results Eighteen patients (men:women, 15:3; median age, 72 years; range, 53-80) were enrolled. Twelve patients improved their DS at 12 weeks (% DS improved, 66.7%; 90% CI, 44.6%-84.4%). Also, 8 of 11 patients (72.7%) after esophagectomy, 4 of 6 patients (66.7%) after ESD, and 3 of 4 patients (75%) after CRT improved at 12 weeks. Three patients who were treated with esophagectomy maintained their DS improvement at 24 weeks (% DS improved, 16.7%; 95% CI, 3.6%-41.4%). The median DFS was 14.1 weeks (95% CI, 13.0-19.0). One patient who had ESD and CRT developed an esophagobronchial fistula 3 months after stent placement. Conclusions Biodegradable stents are effective and tolerable for refractory benign esophageal strictures after treatment for esophageal cancer; however, long-term efficacy was limited, especially after ESD or CRT. (Clinical trial registration number: UMIN000008054.) |
| Databáze: | OpenAIRE |
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