The Experts below are selected from a list of 2037 Experts worldwide ranked by ideXlab platform
Peter D Siersema - One of the best experts on this subject based on the ideXlab platform.
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a new fully covered metal Stent with anti migration features for the treatment of malignant dysphagia
Endoscopy, 2014Co-Authors: Daisy Walter, Frank P Vleggaar, Maarten W Van Den Berg, Jeanin E Van Hooft, H Boot, Robert C H Scheffer, Peter D SiersemaAbstract:Background and study aims: A new Esophageal Stent with two anti-migration features was developed to minimize migration. The aim of this study was to evaluate the clinical efficacy and safety of this Stent in patients with malignant dysphagia. Patients and methods: A total of 40 patients with dysphagia due to a malignant obstruction of the esophagus were prospectively enrolled in this cohort study. Results: Stent placement was technically successful in 39 patients (98 %). The median dysphagia-free time after Stent placement was 220 days (95 % confidence interval 94 – 345 days). Nine patients (23 %) experienced recurrent dysphagia due to tissue overgrowth (n = 2), Stent fracture (n = 1), and partial (n = 5) or complete (n = 1) Stent migration. A total of 16 serious adverse events occurred in 14 patients (36 %), with hemorrhage (n = 3) and severe nausea or vomiting (n = 3) being the most common causes. Conclusions: This new Stent design was effective for the palliation of malignant dysphagia and had a low rate of recurrent dysphagia. However, despite the anti-migration features, Stent migration was still a major cause of recurrent dysphagia. Furthermore, treatment was associated with a high adverse event rate. Dutch Trial Registration (NTR 3313)
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removable self expanding plastic Esophageal Stent as a continuous non permanent dilator in treating refractory benign Esophageal strictures a prospective two center study
The American Journal of Gastroenterology, 2008Co-Authors: Kulwinder S Dua, Frank P Vleggaar, Rajesh Santharam, Peter D SiersemaAbstract:Removable Self-Expanding Plastic Esophageal Stent as a Continuous, Non-Permanent Dilator in Treating Refractory Benign Esophageal Strictures: A Prospective Two-Center Study
Matthias Kirsch - One of the best experts on this subject based on the ideXlab platform.
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multidisciplinary therapy of a large esophago pericardial fistula arising from barrett s esophagus
The Annals of Thoracic Surgery, 2008Co-Authors: Firas Ali, Ahmed Mostafa, Antoine Charachon, Mehdi Karoui, Daniel Loisance, Matthias KirschAbstract:Esophago-pericardial fistula is a rare complication of benign Esophageal pathologies. We present the case report of a patient with Barrett's esophagus complicated by an esophago-pericardial fistula managed by a multi-therapeutic approach to close the fistula using an autologous pericardial patch; placement of a coated, expandable, metallic Esophageal Stent; and a feeding jejunostomy.
Lizhong Sun - One of the best experts on this subject based on the ideXlab platform.
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a successful three stage surgical treatment for aortoEsophageal fistula after thoracic endovascular aortic repair and Esophageal Stent repair
The Annals of Thoracic Surgery, 2016Co-Authors: Lijian Cheng, Junming Zhu, Xiangyang Liu, Wei Liu, Jie Zhang, Jiexiong Liang, Lizhong SunAbstract:A 39-year-old man with Stanford B aortic dissection was treated by thoracic endovascular aortic repair (TEVAR) and experienced an aortoEsophageal fistula (AEF). After repeated TEVAR and Esophageal Stent implantation, the hematemesis did not cease although the whole thoracic descending aorta was covered by Stents. A three-stage operation was performed, and an AEF 9 cm long was found during the operation. To our knowledge, this may be the largest AEF ever reported. The patient survived without adverse events.
Michael A Manfredi - One of the best experts on this subject based on the ideXlab platform.
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endoscopic management of anastomotic Esophageal strictures secondary to Esophageal atresia
Gastrointestinal Endoscopy Clinics of North America, 2016Co-Authors: Michael A ManfrediAbstract:The reported incidence of anastomotic stricture after Esophageal atresia repair has varied in case series from as low as 9% to as high as 80%. The cornerstone of Esophageal stricture treatment is dilation with either balloon or bougie. The goal of Esophageal dilation is to increase the luminal diameter of the esophagus while also improving dysphagia symptoms. Once a stricture becomes refractory to Esophageal dilation, there are several treatment therapies available as adjuncts to dilation therapy. These therapies include intralesional steroid injection, mitomycin C, Esophageal Stent placement, and endoscopic incisional therapy.
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externally removable Stents in the treatment of benign recalcitrant strictures and Esophageal perforations in pediatric patients with Esophageal atresia
Gastrointestinal Endoscopy, 2014Co-Authors: Michael A Manfredi, Russell W Jennings, Waseem M Anjum, Thomas E Hamilton, Jason C Smithers, Jenifer R LightdaleAbstract:Background We investigated whether removable Stents, such as self-expandable plastic Stents (SEPSs) and fully covered self-expandable metal Stents (FCSEMSs) could provide an alternative treatment for recalcitrant strictures and Esophageal perforations after Esophageal atresia (EA) repair. Objective The primary aim of our study was to evaluate technical feasibility. Secondary aims were to evaluate safety and procedural success. Design Retrospective study. Setting Tertiary-care referral center. Patients A total of 24 children with EA. Interventions Retrospective review of all children with EA who underwent dilation and Esophageal Stent placement from January 2010 to February 2013 at our institution. Main Outcome Measurements Healing of perforation and stricture resolution at 30 and 90 days. Results A total of 41 Stents (SEPSs 14, FCSEMSs 27) were placed in 24 patients with EA during the study period, including 14 who had developed Esophageal leaks. Procedural success of Esophageal Stent placement in the treatment of refractory strictures was 39% at 30 days and 26% at 90 days. The success rate was 80% for closure of Esophageal perforations with Stent therapy after dilation and 25% for perforations associated with surgical repair. Adverse events of Stent placement included migration (21% of SEPSs and 7% of FCSEMSs), granulation tissue (37% of FCSEMSs), and deep ulcerations (22% of FCSEMSs). Limitations Retrospective study with small sample size. Conclusion SEPSs and FCSEMSs can be placed successfully in small infants and children with a history of EA repair. The Stents appear to be safe and beneficial in closing Esophageal perforations, especially post-dilation. However, a high stricture recurrence rate after Stent removal may limit their usefulness in treating recalcitrant Esophageal anastomotic strictures.
Jaime Bosch - One of the best experts on this subject based on the ideXlab platform.
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Esophageal balloon tamponade versus Esophageal Stent in controlling acute refractory variceal bleeding a multicenter randomized controlled trial
Hepatology, 2016Co-Authors: Angels Escorsell, Oana Pavel, Andres Cardenas, R Morillas, Elba Llop, Candid Villanueva, Juan Carlos Garciapagan, Jaime BoschAbstract:Balloon tamponade is recommended only as a “bridge” to definitive therapy in patients with cirrhosis and massive or refractory Esophageal variceal bleeding (EVB), but is frequently associated with rebleeding and severe complications. Preliminary, noncontrolled data suggest that a self-expandable, Esophageal covered metal Stent (SX-ELLA Danis; Ella-CS, Hradec Kralove, Czech Republic) may be an effective and safer alternative to balloon tamponade. We conducted a randomized, controlled trial aimed at comparing Esophageal Stent versus balloon tamponade in patients with cirrhosis and EVB refractory to medical and endoscopic treatment. Primary endpoint was success of therapy, defined as survival at day 15 with control of bleeding and without serious adverse events (SAEs). Twenty-eight patients were randomized to Sengstaken-Blakemore tube (n = 15) or SX-ELLA Danis Stent (n = 13). Patients were comparable in severity of liver failure, active bleeding at endoscopy, and initial therapy. Success of therapy was more frequent in the Esophageal Stent than in balloon tamponade group (66% vs. 20%; P = 0.025). Moreover, control of bleeding was higher (85% vs. 47%; P = 0.037) and transfusional requirements (2 vs 6 PRBC; P = 0.08) and SAEs lower (15% vs. 47%; P = 0.077) in the Esophageal Stent group. TIPS was used more frequently in the tamponade group (4 vs. 10; P = 0.12). There were no significant differences in 6-week survival (54% vs. 40%; P = 0.46). Conclusion: Esophageal Stents have greater efficacy with less SAEs than balloon tamponade in the control of EVB in treatment failures. Our findings favor the use of Esophageal Stents in patients with EVB uncontrolled with medical and endoscopic treatment. (Hepatology 2016;63:1957-1967)