Abstract:

BACKGROUND: With continuous progress in esophageal stent technology, retrievable esophageal covered stents are widely used in the treatment of benign esophageal stenosis.
OBJECTIVE: To compare the efficacy, biocompatibility and safety of traditional dilator therapy versus retrievable esophageal covered stent therapy in the treatment of benign esophageal stenosis.
METHODS: Fifty-four cases with esophageal anastomotic stenosis were voluntarily divided into dilator group and stent group. Stent group was implanted with two different types of nickel-titanium shape memory alloy stents of MTN-SE-G-18/60 and MTN-SE-G-20/60, for patients with different anastomosis diameter. Dilator group was given silicone expandor. Anastomotic size, degree of dysphagia and complications were measured during 1, 3, 6 months follow-up after treatment.
RESULTS AND CONCLUSION: Due to repeated dilation, the throat pain and the incidence of local bleeding were significantly higher in dilator group than those in stent group, and 1 case exhibited esophageal perforation. For the two groups of patients at 1, 3, 6 months after treatment, the diameter of the anastomotic stoma were gradually decreased, but significantly increased compared with before treatment. The anastomotic expansion and dysphagia improvements were better in stent group than that in dilator group, especially at 6 months, the anastomotic diameters were average 0.94 cm and 0.63 cm, respectively (P < 0.01), and the ratio of eating normally was 88% and 48% respectively (P = 0.005). In comparison with the dilator therapy, the treatment of esophageal anastomotic stricture with retrievable covered stents under endoscope is simple, less complications, safe, little pain, easy to accept and with excellent long-term effect.