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What is the optimal duration of stent placement for refractory, benign esophageal strictures?

Nature Reviews Gastroenterology & Hepatology volume 6, pages 146–147 (2009)Cite this article

Refractory, benign esophageal strictures (RBES) are those that cannot be dilatated to an adequate diameter, recur within a short time interval, or require ongoing dilatation. The most common causes of RBES include ingestion of caustic substances, radiation injuries, anastomotic strictures and severe peptic injuries.1 Poor response to dilatation in RBES is attributed to an ongoing inflammatory process in the esophageal wall. A prolonged period of dilatation has, therefore, been suggested for these strictures. Self-expanding metal stents (SEMS) and, more recently, self-expanding plastic stents (SEPS) have been introduced as treatment modalities for RBES.2

The optimal duration of stent placement for RBES is unknown, but different studies have proposed durations that vary between 2 weeks and 2 years.2 As their findings differ, these studies cannot be used to determine the optimum duration of stent placement. Optimal treatment is dependent on several factors, particularly the type of stent used, the location of the stricture, the underlying cause and length of the stricture, and the severity of the underlying inflammatory process, which is, among other factors, determined by duration of symptoms before stent placement. Risk of esophageal stricture recurrence is reported to be increased with an increased stricture length.3 Types of stent that have been used to dilatate RBES include partially covered and fully covered SEMS, and fully covered SEPS.

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Authors and Affiliations

  1. PD Siersema is Professor of Gastroenterology and Head of the Department and MMC Hirdes is a Research Fellow in the same department, Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.,

    Peter D Siersema & Meike MC Hirdes

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  1. Peter D Siersema
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  2. Meike MC Hirdes
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Correspondence to Peter D Siersema.

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The authors declare no competing financial interests.

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Siersema, P., Hirdes, M. What is the optimal duration of stent placement for refractory, benign esophageal strictures?. Nat Rev Gastroenterol Hepatol 6, 146–147 (2009). https://doi.org/10.1038/ncpgasthep1364

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