Cargando…

Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature

BACKGROUND: The endoscopic management of benign short post-anastomotic ileocolonic stricture (PAICS) that is refractory to primary and secondary treatment modalities remains challenging. The lumen-apposing metal stent (LAMS) is a novel device recently developed for therapeutic gastrointestinal endos...

Descripción completa

Detalles Bibliográficos
Autores principales: Kasapidis, Panagiotis, Mavrogenis, Georgios, Mandrekas, Dimitrios, Bazerbachi, Fateh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561585/
https://www.ncbi.nlm.nih.gov/pubmed/36246813
http://dx.doi.org/10.12998/wjcc.v10.i28.10162
_version_ 1784807978511106048
author Kasapidis, Panagiotis
Mavrogenis, Georgios
Mandrekas, Dimitrios
Bazerbachi, Fateh
author_facet Kasapidis, Panagiotis
Mavrogenis, Georgios
Mandrekas, Dimitrios
Bazerbachi, Fateh
author_sort Kasapidis, Panagiotis
collection PubMed
description BACKGROUND: The endoscopic management of benign short post-anastomotic ileocolonic stricture (PAICS) that is refractory to primary and secondary treatment modalities remains challenging. The lumen-apposing metal stent (LAMS) is a novel device recently developed for therapeutic gastrointestinal endoscopy. LAMSs have demonstrated significantly better results with regard to stent migration than fully covered self-expandable metal stents (FCSEMSs). CASE SUMMARY: This article presents six cases of symptomatic PAICS successfully treated with a LAMS and a review of the relevant literature. We report a life-saving technique not previously documented and the use of technology to improve patient outcomes. The six patients (median age, 75 years) suffered from vomiting, constipation and recurrent abdominal pain, with symptoms starting 23-25 wk post-surgery. The median stricture length was 1.83 cm. All six patients underwent successful and uneventful bi-flanged metal stent (BFMS)-LAMS placement for benign PAICS. All patients remained asymptomatic during the three months of stent indwelling and up to a median of 7 mo after stent removal. According to the literature, the application of LAMS for PAICS is associated with a < 10% risk of migration and a < 5% risk of bleeding. Conversely, FCSEMS has a high migration rate (15%-50%). CONCLUSION: The evolving role of interventional endoscopy and the availability of LAMSs provide patients with minimally invasive treatment options, allowing them to avoid more invasive surgical interventions. The BFMS (NAGI stent) is longer and larger than the prototype AXIOS-LAMS, which should be considered in the management of short ileocolonic post-anastomotic strictures longer than 10 mm and shorter than 30 mm.
format Online
Article
Text
id pubmed-9561585
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-95615852022-10-15 Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature Kasapidis, Panagiotis Mavrogenis, Georgios Mandrekas, Dimitrios Bazerbachi, Fateh World J Clin Cases Case Report BACKGROUND: The endoscopic management of benign short post-anastomotic ileocolonic stricture (PAICS) that is refractory to primary and secondary treatment modalities remains challenging. The lumen-apposing metal stent (LAMS) is a novel device recently developed for therapeutic gastrointestinal endoscopy. LAMSs have demonstrated significantly better results with regard to stent migration than fully covered self-expandable metal stents (FCSEMSs). CASE SUMMARY: This article presents six cases of symptomatic PAICS successfully treated with a LAMS and a review of the relevant literature. We report a life-saving technique not previously documented and the use of technology to improve patient outcomes. The six patients (median age, 75 years) suffered from vomiting, constipation and recurrent abdominal pain, with symptoms starting 23-25 wk post-surgery. The median stricture length was 1.83 cm. All six patients underwent successful and uneventful bi-flanged metal stent (BFMS)-LAMS placement for benign PAICS. All patients remained asymptomatic during the three months of stent indwelling and up to a median of 7 mo after stent removal. According to the literature, the application of LAMS for PAICS is associated with a < 10% risk of migration and a < 5% risk of bleeding. Conversely, FCSEMS has a high migration rate (15%-50%). CONCLUSION: The evolving role of interventional endoscopy and the availability of LAMSs provide patients with minimally invasive treatment options, allowing them to avoid more invasive surgical interventions. The BFMS (NAGI stent) is longer and larger than the prototype AXIOS-LAMS, which should be considered in the management of short ileocolonic post-anastomotic strictures longer than 10 mm and shorter than 30 mm. Baishideng Publishing Group Inc 2022-10-06 2022-10-06 /pmc/articles/PMC9561585/ /pubmed/36246813 http://dx.doi.org/10.12998/wjcc.v10.i28.10162 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Kasapidis, Panagiotis
Mavrogenis, Georgios
Mandrekas, Dimitrios
Bazerbachi, Fateh
Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
title Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
title_full Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
title_fullStr Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
title_full_unstemmed Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
title_short Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
title_sort short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: six case reports and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561585/
https://www.ncbi.nlm.nih.gov/pubmed/36246813
http://dx.doi.org/10.12998/wjcc.v10.i28.10162
work_keys_str_mv AT kasapidispanagiotis shortbenignileocolonicanastomoticstricturesmanagementwithbiflangedmetalstentssixcasereportsandreviewofliterature
AT mavrogenisgeorgios shortbenignileocolonicanastomoticstricturesmanagementwithbiflangedmetalstentssixcasereportsandreviewofliterature
AT mandrekasdimitrios shortbenignileocolonicanastomoticstricturesmanagementwithbiflangedmetalstentssixcasereportsandreviewofliterature
AT bazerbachifateh shortbenignileocolonicanastomoticstricturesmanagementwithbiflangedmetalstentssixcasereportsandreviewofliterature