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Background <p>Removable, fully covered, self-expanding metallic stents (FCSEMS) are mainly recommended to avoid multiple dilatations when treating refractory benign esophageal strictures. However, early application of FCSEMS in non-refractory strictures is uncommon in clinical practice. This study aims to evaluate the safety, efficacy and cost-effectiveness of using FCSEMS to treat corrosive esophageal and gastric strictures (CEGS).</p> Materials and methods <p>Medical records of 49 patients with CEGS were retrospectively reviewed. Notably, 18 patients underwent FCSEMS placement with or without dilatation (Stent group), and 31 patients underwent only bougie or balloon dilatation (Dilatation group). Ingested materials, degree of strictures, types of strictures, treatment methods, technical outcomes, hospitalizations, complications and follow-up outcomes were evaluated and compared.</p> Results <p>A total of 458 dilatation sessions were performed with a technical success rate of 88.2% in the Dilatation group and 90.1% in the Stent group (<i>P</i> = 0.5144); dysphagia scores decreased substantially after dilatation in both groups (<i>P</i> &lt; 0.0001). No procedure-related mortality was noted, and the most common complication was mild bleeding. However, esophageal ruptures were observed in two patients in the Dilatation group; one patient was treated via titanium clip closure, and one patient required surgical repair. In the Stent group, stent migration and stent restenosis were observed in five (27.8%) and nine (50.0%) patients, respectively. More major complications were observed in the Stent group (10/18) compared with the Dilatation group (2/31, <i>P</i> = 0.0001). Longer total hospital stays and higher total hospitalization costs occurred in the Stent group. No differences in long-term clinical outcomes were detected between the Stent and Dilatation groups (<i>P</i> = 0.5480).</p> Conclusion <p>Bougie or balloon dilatations are safe, effective and well tolerated in patients with CEGS. Early placement of FCSEMS is associated with longer total hospital stays, higher total hospitalization costs and more major complications, but not better efficacy, compared with dilatation alone. Thus, FCSEMS should be used with caution when treating CEGS.</p>

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Early placement of removable, fully covered, self-expandable metallic stent and a series of dilatations for corrosive oesophageal and gastric strictures: a comparative study

  • 期刊论文

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  • 发表日期：

    2026年5月13日

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  • Huifeng Yuan,
  • Ping Liu,
  • Yonghua Bi

摘要

Background

Removable, fully covered, self-expanding metallic stents (FCSEMS) are mainly recommended to avoid multiple dilatations when treating refractory benign esophageal strictures. However, early application of FCSEMS in non-refractory strictures is uncommon in clinical practice. This study aims to evaluate the safety, efficacy and cost-effectiveness of using FCSEMS to treat corrosive esophageal and gastric strictures (CEGS).

Materials and methods

Medical records of 49 patients with CEGS were retrospectively reviewed. Notably, 18 patients underwent FCSEMS placement with or without dilatation (Stent group), and 31 patients underwent only bougie or balloon dilatation (Dilatation group). Ingested materials, degree of strictures, types of strictures, treatment methods, technical outcomes, hospitalizations, complications and follow-up outcomes were evaluated and compared.

Results

A total of 458 dilatation sessions were performed with a technical success rate of 88.2% in the Dilatation group and 90.1% in the Stent group (P = 0.5144); dysphagia scores decreased substantially after dilatation in both groups (P < 0.0001). No procedure-related mortality was noted, and the most common complication was mild bleeding. However, esophageal ruptures were observed in two patients in the Dilatation group; one patient was treated via titanium clip closure, and one patient required surgical repair. In the Stent group, stent migration and stent restenosis were observed in five (27.8%) and nine (50.0%) patients, respectively. More major complications were observed in the Stent group (10/18) compared with the Dilatation group (2/31, P = 0.0001). Longer total hospital stays and higher total hospitalization costs occurred in the Stent group. No differences in long-term clinical outcomes were detected between the Stent and Dilatation groups (P = 0.5480).

Conclusion

Bougie or balloon dilatations are safe, effective and well tolerated in patients with CEGS. Early placement of FCSEMS is associated with longer total hospital stays, higher total hospitalization costs and more major complications, but not better efficacy, compared with dilatation alone. Thus, FCSEMS should be used with caution when treating CEGS.