HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert C.G. Martin Permission Requests Citing Articles Citing Articles via HighWire Google Scholar Articles by Martin, R. C.G. Articles by Scoggins, C. R. PubMed Articles by Martin, R. C.G. Articles by Scoggins, C. R. Related Collections Esophagus - other

---

Original Articles: General Thoracic

The Use of Self-Expanding Silicone Stents in Esophagectomy Strictures: Less Cost and More Efficiency

Department of Surgery, Division of Surgical Oncology, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, Kentucky

Accepted for publication April 14, 2008.

^_* Address correspondence to Dr Martin, 315 E Broadway, Rm 313l Louisville, KY 40202 (Email: robert.martin{at}louisville.edu).

Background: Benign and postoperative anastomotic esophageal strictures remain a common problem in the management of esophageal diseases and cancer. Repeated dilation remains the most common treatment algorithm. Esophageal stenting with a removable plastic stent is another option. This study evaluated the dysphagia effects and cost of removable silicone stents in the management of benign and postoperative anastomotic strictures compared with standard repeat dilation.

Methods: A matched case-control study was done of benign esophageal stricture treatments from July 2004 to August 2006 in all patients treated for benign esophageal strictures identified in a prospectively maintained esophageal database. Eighteen patients had a retrievable silicone-covered stent placed, and 24 were treated with standard repeated dilations without stents. Early esophageal stenting vs repeated dilation in esophagectomy strictures and other benign strictures was compared.

Results: The median number of dilatations was two (range, 1 to 3) for the 18 stent patients, with all stents placed for 3 months' duration, and four dilations (range, 2 to 12) in 24 patients treated solely with dilatation. An evaluation of median, high, and low total charges, net revenue, and direct margin demonstrated that the use of a removable stent after one failed dilation was more cost-efficient than repeated dilations.

Conclusions: In patients who do not respond to initial dilation, placement of removable esophageal stent at the second dilation leads to improved quality of life and dysphagia relief. Early use of a removable esophageal stent is significantly more cost-efficient when two or more esophageal dilations are avoided.

This article has been cited by other articles:

				S. R. DeMeester Invited commentary. Ann. Thorac. Surg., August 1, 2008; 86(2): 440 - 440. [Full Text] [PDF]