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Use of covered self-expandable stents for benign colorectal disorders in children

Purpose: There is a lack of experience with covered self-expandable stents for benign colorectal disorders in children. Methods: Five children (4M, 1F) with a median age of 5years (range, 6months-9years) who underwent treatment with covered self-expandable plastic (SEPSs) or self-expandable metal st...

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Main Authors: Lange, Bettina (Author) , Sold, Moritz (Author) , Kähler, Georg (Author) , Wessel, Lucas (Author) , Kubiak, Rainer (Author)
Format: Article (Journal)
Language:English
Published: 2017
In: Journal of pediatric surgery
Year: 2017, Volume: 52, Issue: 1, Pages: 184-187
ISSN:1531-5037
DOI:10.1016/j.jpedsurg.2016.01.020
Online Access:Verlag, Volltext: http://dx.doi.org/10.1016/j.jpedsurg.2016.01.020
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0022346816000622
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Author Notes:Bettina Lange, Moritz Sold, Georg Kähler, Lucas M. Wessel, Rainer Kubiak

MARC

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520 |a Purpose: There is a lack of experience with covered self-expandable stents for benign colorectal disorders in children. Methods: Five children (4M, 1F) with a median age of 5years (range, 6months-9years) who underwent treatment with covered self-expandable plastic (SEPSs) or self-expandable metal stents (SEMSs) for a benign colorectal condition between April 2005 and November 2013 were recruited to this retrospective study. Etiologies included: anastomotic stricture with (n=1) or without (n=3) simultaneous enterocutaneous fistula, as well as an anastomotic leak associated with enterocutaneous fistula (n=1). All children suffered from either Hirschsprung's disease (n=3) or total colonic aganglionosis (Zuelzer-Wilson syndrome) (n=2). Results: Median duration of individual stent placement was 23days (range, 1-87days). In all cases up to five different stents were placed over time. At follow-up two patients were successfully treated without further intervention. In another patient the anastomotic stricture resolved fully, but a coexisting enterocutaneous fistula persisted. Overall, three patients did not improve completely following stenting and required definite surgery. Stent-related problems were noted in all cases. There was one perforation of the colon at stent insertion. Further complications consisted of stent dislocation (n=4), obstruction (n=1), formation of granulation tissue (n=1), ulceration (n=1) and discomfort (n=3). Conclusions: Covered self-expandable stents enrich the armamentarium of interventions for benign colorectal disorders in children including anastomotic strictures and intestinal leaks. A stent can be applied either as an emergency procedure (bridge to surgery) or as an adjuvant treatment further to endoscopy and dilatation. Postinterventional problems are frequent but there is a potential for temporary or definite improvement following stent insertion. 
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