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Uncovered self-expanding metal stents offer effective relief for colonic obstruction. Dr Vanbiervliet and colleagues from France determined the effectiveness of fully covered self-expanding metal stents in the treatment of benign colonic strictures. All patients presenting with a symptomatic benign colonic stricture during a 6-year study period were treated with fully covered self-expanding metal stents. The stents were placed and removed 4 - 6 weeks later at one of 10 endoscopy centers.  | | 26% reported pain exacerbation | | Gastrointestinal Endoscopy |
The efficacy of the stent, technical success, stent retrieval, safety, and recurrence of symptoms were evaluated during follow-up. Univariate and multivariate analyses were performed to identify variables associated with clinical success, stent migration, and symptom recurrence. The research team evaluated 43 patients with occlusive or subocclusive symptoms due to anastomotic, post-ischemic, or post-radiation strictures. The researchers found that insertion was successful in all patients. Clinical success was obtained in 81% of patients. The research team observed migration in 63% of patients. The team noted that the median duration of stenting was 21 days. The researchers showed that stents more than 20 mm wide migrated significantly less often. Recurrence of obstructive symptoms was observed in 53% of patients, irrespective of migration. No predictive factors for recurrence or clinical efficacy were found. Dr Vanbiervliet's team concludes, "Fully covered self-expanding metal stents for treatment of symptomatic benign colonic strictures are safe and effective, despite a high rate of spontaneous migration."
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