Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases

BackgroundTemporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases.ObjectiveTo evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases.DesignMulticenter retrospective study.SettingSix tertiary care centers in the United States and Europe.PatientsA total of 214 patients with benign esophageal diseases undergoing endoscopic stent removal.InterventionEndoscopic stent removal.Main Outcome MeasurementsEndoscopic techniques for stent removal, time to stent removal, and adverse events related to stent removal.ResultsA total of 214 patients underwent a total of 329 stent extractions. Stents were mainly placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents, 52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic stents. A total of 35 (10.6%) procedure-related adverse events were reported, including 7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs (P < .001) was a risk factor for adverse events during stent removal. Favorable factors for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194).LimitationsRetrospective analysis, only tertiary care centers.ConclusionsWith an acceptable major adverse event rate of 2.1%, esophageal stent removal in the setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse events caused by stent removal were not time dependent.