Endoscopic suturing for the prevention of stent migration in benign upper gastrointestinal conditions: A comparative multicenter study

Saowanee Ngamruengphong, Reem Z. Sharaiha, Amrita Sethi, Ali A. Siddiqui, Christopher J. Dimaio, Susana Gonzalez, Jennifer Im, Jason N. Rogart, Sophia Jagroop, Jessica Widmer, Raza Abbas Hasan, Sobia Laique, Tamas Gonda, John Poneros, Amit Desai, Amy Tyberg, Vivek Kumbhari, Mohamad El Zein, Ahmed Abdelgelil, Sepideh BesharatiRuben Hernaez, Patrick I. Okolo, Vikesh Singh, Anthony N Kalloo, Michel Kahaleh, Mouen Khashab

Research output: Contribution to journalArticle

Abstract

Background and study aims: Fully covered self-expandable metal stents (FCSEMSs) have increasingly been used in benign upper gastrointestinal (UGI) conditions; however, stent migration remains a major limitation. Endoscopic suture fixation (ESF) may prevent stent migration. The aims of this study were to compare the frequency of stent migration in patients who received endoscopic suturing for stent fixation (ESF group) compared with those who did not (NSF group) and to assess the impact of ESF on clinical outcome. Patients and methods: This was a retrospective study of patients who underwent FCSEMS placement for benign UGI diseases. Patients were divided into either the NSF or ESF group.‚Outcome variables, including stent migration, clinical success (resolution of underlying pathology), and adverse events, were compared. Results: A total of 125 patients (44 in ESF group, 81 in NSF group; 56 benign strictures, 69 leaks/fistulas/perforations) underwent 224 stenting procedures. Stent migration was significantly more common in the NSF group (33% vs. 16%; P=0.03). Time to stent migration was longer in the ESF group (P=0.02). ESF appeared to protect against stent migration in patients with a history of stent migration (adjusted odds ratio [OR] 0.09; P=0.002). ESF was also significantly associated with a higher rate of clinical success (60% vs. 38%; P=0.03). Rates of adverse events were similar between the two groups. Conclusions: Endoscopic suturing for stent fixation is safe and associated with a decreased migration rate, particularly in patients with a prior history of stent migration. It may also improve clinical response, likely because of the reduction in stent migration.

Original languageEnglish (US)
Pages (from-to)802-808
Number of pages7
JournalEndoscopy
Volume48
Issue number9
DOIs
StatePublished - Sep 1 2016

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Multicenter Studies
Stents
Sutures
Gastrointestinal Diseases
Fistula
Pathologic Constriction
Retrospective Studies
Odds Ratio
Pathology

ASJC Scopus subject areas

  • Gastroenterology

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Endoscopic suturing for the prevention of stent migration in benign upper gastrointestinal conditions : A comparative multicenter study. / Ngamruengphong, Saowanee; Sharaiha, Reem Z.; Sethi, Amrita; Siddiqui, Ali A.; Dimaio, Christopher J.; Gonzalez, Susana; Im, Jennifer; Rogart, Jason N.; Jagroop, Sophia; Widmer, Jessica; Hasan, Raza Abbas; Laique, Sobia; Gonda, Tamas; Poneros, John; Desai, Amit; Tyberg, Amy; Kumbhari, Vivek; El Zein, Mohamad; Abdelgelil, Ahmed; Besharati, Sepideh; Hernaez, Ruben; Okolo, Patrick I.; Singh, Vikesh; Kalloo, Anthony N; Kahaleh, Michel; Khashab, Mouen.

In: Endoscopy, Vol. 48, No. 9, 01.09.2016, p. 802-808.

Research output: Contribution to journalArticle

Ngamruengphong, S, Sharaiha, RZ, Sethi, A, Siddiqui, AA, Dimaio, CJ, Gonzalez, S, Im, J, Rogart, JN, Jagroop, S, Widmer, J, Hasan, RA, Laique, S, Gonda, T, Poneros, J, Desai, A, Tyberg, A, Kumbhari, V, El Zein, M, Abdelgelil, A, Besharati, S, Hernaez, R, Okolo, PI, Singh, V, Kalloo, AN, Kahaleh, M & Khashab, M 2016, 'Endoscopic suturing for the prevention of stent migration in benign upper gastrointestinal conditions: A comparative multicenter study', Endoscopy, vol. 48, no. 9, pp. 802-808. https://doi.org/10.1055/s-0042-108567
Ngamruengphong, Saowanee ; Sharaiha, Reem Z. ; Sethi, Amrita ; Siddiqui, Ali A. ; Dimaio, Christopher J. ; Gonzalez, Susana ; Im, Jennifer ; Rogart, Jason N. ; Jagroop, Sophia ; Widmer, Jessica ; Hasan, Raza Abbas ; Laique, Sobia ; Gonda, Tamas ; Poneros, John ; Desai, Amit ; Tyberg, Amy ; Kumbhari, Vivek ; El Zein, Mohamad ; Abdelgelil, Ahmed ; Besharati, Sepideh ; Hernaez, Ruben ; Okolo, Patrick I. ; Singh, Vikesh ; Kalloo, Anthony N ; Kahaleh, Michel ; Khashab, Mouen. / Endoscopic suturing for the prevention of stent migration in benign upper gastrointestinal conditions : A comparative multicenter study. In: Endoscopy. 2016 ; Vol. 48, No. 9. pp. 802-808.
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T1 - Endoscopic suturing for the prevention of stent migration in benign upper gastrointestinal conditions

T2 - A comparative multicenter study

AU - Ngamruengphong, Saowanee

AU - Sharaiha, Reem Z.

AU - Sethi, Amrita

AU - Siddiqui, Ali A.

AU - Dimaio, Christopher J.

AU - Gonzalez, Susana

AU - Im, Jennifer

AU - Rogart, Jason N.

AU - Jagroop, Sophia

AU - Widmer, Jessica

AU - Hasan, Raza Abbas

AU - Laique, Sobia

AU - Gonda, Tamas

AU - Poneros, John

AU - Desai, Amit

AU - Tyberg, Amy

AU - Kumbhari, Vivek

AU - El Zein, Mohamad

AU - Abdelgelil, Ahmed

AU - Besharati, Sepideh

AU - Hernaez, Ruben

AU - Okolo, Patrick I.

AU - Singh, Vikesh

AU - Kalloo, Anthony N

AU - Kahaleh, Michel

AU - Khashab, Mouen

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background and study aims: Fully covered self-expandable metal stents (FCSEMSs) have increasingly been used in benign upper gastrointestinal (UGI) conditions; however, stent migration remains a major limitation. Endoscopic suture fixation (ESF) may prevent stent migration. The aims of this study were to compare the frequency of stent migration in patients who received endoscopic suturing for stent fixation (ESF group) compared with those who did not (NSF group) and to assess the impact of ESF on clinical outcome. Patients and methods: This was a retrospective study of patients who underwent FCSEMS placement for benign UGI diseases. Patients were divided into either the NSF or ESF group.‚Outcome variables, including stent migration, clinical success (resolution of underlying pathology), and adverse events, were compared. Results: A total of 125 patients (44 in ESF group, 81 in NSF group; 56 benign strictures, 69 leaks/fistulas/perforations) underwent 224 stenting procedures. Stent migration was significantly more common in the NSF group (33% vs. 16%; P=0.03). Time to stent migration was longer in the ESF group (P=0.02). ESF appeared to protect against stent migration in patients with a history of stent migration (adjusted odds ratio [OR] 0.09; P=0.002). ESF was also significantly associated with a higher rate of clinical success (60% vs. 38%; P=0.03). Rates of adverse events were similar between the two groups. Conclusions: Endoscopic suturing for stent fixation is safe and associated with a decreased migration rate, particularly in patients with a prior history of stent migration. It may also improve clinical response, likely because of the reduction in stent migration.

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