Covered retrievable metal stent in the treatment of refractory benign esophageal stricture

Objective To evaluate the efficacy and safety of the covered retrievable metal stent in the treatment of refractory benign esophageal stricture. Methods Six patients with refractory benign esophageal stricture who failed in endoscopic dilation were selected. There were 3 cases of stricture after caustic chemical ingestion, 2 cases of anastomotic stricture after surgery, and 1 case of re-stricture after metal stenting. The shape and diameter of the covered stent were individually designed. Stent was placed across the esophageal stricture. Symptoms after stenting, mucosal hyperplasia at the ends of stent and symptoms after retrieval of stent were followed up. Results Stent placement was performed successfully in all patients. After the stent placement, dysphagia was resolved, and all patients could consume soft food. Three to six months after stenting, all the stents were removed successfully by endoscopy. No mucosal hyperplasia and re-stricture occurred. In 4 cases, after stent had been removed, followed up for 2 to 12 months, symptoms of dysphagia were resolved persistently, and no further treatment was necessary. In the other 2 cases, the stent migrated, and dysphagia recurred within 1 month after removal of the stent. Besides one case of retrostemal pain after stenting, no other complication was noted. Conclusion Individually designed covered retrievable metal stent is a safe and effective way to treat refractory benign esophageal stricture.