P608 New anti-migration extractible metal stents for Crohn's disease strictures: a nationwide GETAID-SFED cohort study

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Abstract

Background: In Crohn's disease (CD), strictures are frequent and may require surgical resection or endoscopic balloon dilation. Full covered metal stenting has been abandoned due to the high migration rate. A new anti-migration shaped self-expandable and extractible metal stent (SEEMS) is available. We evaluated its efficacy and safety in a real life cohort.

Methods: All GETAID and SFED centers were asked to collect retrospectively or prospectively all data on patients who had a SEEMS for a Crohn's disease stricture. The SEEMS (Hanarostent HRC-20-080-230 – MITech, distributed by Life Partner Europe) was maintained 7 days before its extraction during a second colonoscopy. Short- and long-term outcomes were evaluated.

Results: 38 patients were enrolled in the study between June 2015 and October 2016 Mean age was 47 years, and 61% were men. CD strictures were anastomotic and unique in 68% of cases. The median (± SE) length of the stricture evaluated by cross-sectional imaging and during colonoscopy was 3±1.9 and 2±1.4 cm, respectively. Immediate success (no obstructive symptom at day 30) was reported in 79% of cases. Among them, 6 (20%) and 4 (13%) patients needed a new balloon dilation or surgery during follow-up, respectively. 42% of patients were obstruction-free without any intervention after a mean follow-up of 18 months (range, 1–58). No perforation occurred and 2 migrations were observed (5%).

Conclusions: SEEMS is safe, with no perforation reported in this study, and has a very low migration rate. Whether SEEMS is superior to standard balloon dilatation will require additional investigation.

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