The role of biodegradable stents in the management of benign and malignant oesophageal strictures: A cohort study.

BACKGROUND: Oesophageal strictures can be caused by benign or malignant processes. Up to 10% of patients with a benign stricture are refractory to pneumatic dilatation and may benefit from biodegradable stent (BD) insertion. Biodegradable stents also have a role in malignant oesophageal strictures to facilitate enteral nutrition while staging or neo-adjuvant treatment is completed. The aim of this study was to review the safety and efficacy of BD stents in the management of benign or malignant oesophageal strictures.

METHODS: A single centre retrospective cohort study was performed. Dysphagia was graded before and after stenting using a validated score. All patients were followed up for at least 30 days and all adverse events were recorded.

RESULTS: Twenty eight stents were inserted in 20 patients; 11 for malignant and 17 for benign disease. One further attempted stenting was impossible due to a high benign stricture. There were no perforations and the 30-day mortality rate was zero. Mean dysphagia scores improved from 2.65 to 1.00 (p value <0.001) in benign disease and from 3.27 to 1.36 (p value <0.001) in patients with malignant disease. Surgical resection was not compromised following stent insertion in the malignant group.

CONCLUSIONS: Biodegradable stent insertion is a safe and efficacious adjunct in the treatment of benign and malignant oesophageal strictures. In malignant disease, BD stent insertion can maintain enteral nutrition while staging or neo-adjuvant therapy is completed without adversely impacting on surgical resection.