Esophageal stents as a salvage therapy for non-malignant iatrogenic esophageal perforations

Esophageal non-malignant perforations are severe life-threatening conditions. The current treatment is either surgical or conservative.

We report a case series of 3 consecutive patients (1 female, 2 male; 34-68 years) treated with expandable covered stents for non-malignant iatrogenic esophageal perforations.

In our series, 3 out of 3 patients sealed their perforations and resumed normal oral intake. Complications observed were 2 stent migrations, which occurred at 6 and 11 months after stent insertion, a stenosis due to acid reflux treated by another stent insertion above the first one. On the basis of the data available, it appears that esophageal stents was successful in 82% of the cases. The mortality and complication rates were of 7% and 32% respectively. The main complications observed were peptic stenosis above the stent and fistulas.

These results are promising but need to be confirmed in large-scale prospective studies. Mediastinal drainage remains mandatory when sepsis is present.