Original articleClinical endoscopyChanging epidemiology of esophageal stent placement for dysphagia: a decade of trends and the impact of benign indications
Section snippets
Data source
The National Inpatient Sample (NIS) is part of the Healthcare Cost Utilization Project and the largest publicly available database in the United States.19 The NIS has unweighted data from more than 8 million hospital stays that represent a weighted estimate of 35 million hospitalizations every year. The database is able to provide national estimates of patient demographics, hospital characteristics, procedures performed, and discharge diagnoses based on a 20% stratified probability sample.
Temporal trends for ES placement in patients with dysphagia
Between 2003 and 2013, among 21,522 ESs placed in hospitalized patients, 7198 were placed endoscopically for those with an ICD-9-CM code of dysphagia (Table 1). The remaining 14,324 patients (39% for nonmalignant etiology) were excluded because of a lack of ICD-9-CM code for dysphagia during their hospitalization when the ES was placed (Supplementary Table 3, available online at www.giejournal.org). There was a significant increase in the rate of endoscopic ES placement for patients with
Discussion
In this population-based study, we have evaluated national trends for endoscopic placement of ESs in hospitalized patients with dysphagia. The number of ESs placed more than tripled between 2003 and 2013. Although the number of stents placed for benign indications increased over 8-fold, there was a modest 3-fold increase in stents for malignant indications as well. Adjusting for multiple demographic and hospital variables, the increase in benign indications was significantly associated with ES
References (49)
- et al.
Enteral stents
Gastrointest Endosc
(2011) - et al.
Prior radiation and chemotherapy increase the risk of life-threatening complications after insertion of metallic stents for esophagogastric malignancy
Gastrointest Endosc
(1996) - et al.
Treatment of esophageal leaks, fistulae, and perforations with temporary stents: evaluation of efficacy, adverse events, and factors associated with successful outcomes
Gastrointest Endosc
(2014) - et al.
Management of a tracheoesophageal fistula with a silicone-covered self-expanding metal stent
Gastrointest Endosc
(1994) - et al.
Palliative chemoradiotherapy versus radiotherapy alone for dysphagia in advanced oesophageal cancer: a multicentre randomised controlled trial (TROG 03.01)
Lancet Gastroenterol Hepatol
(2018) - et al.
A prospective, randomized, controlled trial of covered expandable metal stents in the palliation of malignant esophageal obstruction at the gastroesophageal junction
Am J Gastroenterol
(2001) Minimizing endoscopic complications: endoluminal stents
Gastrointest Endosc Clin North Am
(2007)- et al.
A new fully covered metal stent for the treatment of benign and malignant dysphagia: a prospective follow-up study
Gastrointest Endosc
(2012) - et al.
Self-expanding plastic stents in treatment of benign esophageal conditions
Gastrointest Endosc
(2008) - et al.
Endoscopic suturing of esophageal fully covered self-expanding metal stents reduces rates of stent migration
Gastrointest Endosc
(2017)
The role of endoscopy in the assessment and treatment of esophageal cancer
Gastrointest Endosc
Stent placement or brachytherapy for palliation of dysphagia from esophageal cancer: a prognostic model to guide treatment selection
Gastrointest Endosc
Role of esophageal stents in benign and malignant diseases
Am J Gastroenterol
Fully vs. partially covered self expandable metal stent for palliation of malignant esophageal strictures: a randomized trial (the COPAC study)
Endoscopy
Efficacy and safety of fully covered self-expanding metal stents for malignant esophageal obstruction
Dig Dis Sci
Does chemoradiation therapy increase the incidence of complications with self-expanding coated stents in the management of malignant esophageal strictures?
Am J Gastroenterol
Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia
Jpn J Thorac Cardiovasc Surg
A controlled trial of an expansile metal stent for palliation of esophageal obstruction due to inoperable cancer
N Engl J Med
Metal stents improve dysphagia, nutrition and survival in malignant oesophageal stenosis: a randomized controlled trial comparing modified Gianturco Z-stents with plastic Atkinson tubes
Eur J Gastroenterol Hepatol
Self-expanding metal stents versus plastic prostheses in the palliation of malignant dysphagia: long-term outcome of 153 consecutive patients
J Clin Gastroenterol
Stenting for benign esophageal strictures
Endoscopy
Esophageal stenting in clinical practice: an overview
Curr Treat Options Gastroenterol
Endoscopic management of benign esophageal strictures
Curr Gastroenterol Rep
Fully covered self-expanding metallic stent placement for benign refractory esophageal strictures
Indian J Gastroenterol
Cited by (0)
DISCLOSURE: All authors disclosed no financial relationships.
If you would like to chat with an author of this article, you may contact Dr Krishna at [email protected].