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Endoluminal Silicone-Covered Stenting in Children: Novel Applications and Lessons Learned
Anuradha D Patel1, Roshan D'Cruz2, Jacob Olson1
1Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Insights
Retrievable silicone-covered stents show promise for pediatric hollow visceral disorders. While acute conditions respond well, chronic fistulas may need further intervention.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Surgery
- Biomaterials Engineering
Background:
- Silicone-covered endoluminal stents are used for visceral disorders in adults.
- Their efficacy in pediatric patients is not well-established.
Purpose of the Study:
- To assess the application and outcomes of endoluminal silicone-covered stenting in children.
- To evaluate evolving uses of this technology in pediatric patients.
Main Methods:
- Retrospective review of eight pediatric patients (≤19 years) undergoing stent placement.
- Data collected from 2014-2021 at a single institution for various indications.
Main Results:
- Twenty-six silicone-covered stents were placed in eight patients.
- Adverse events occurred in 15.4% of placements.
- Clinical benefit was observed in novel applications like vaginal atresia and post-anastomosis disruption.
Conclusions:
- Endoluminal silicone-covered stenting has broad applications in pediatric patients.
- Acute pediatric conditions show rapid positive response to stenting.
- Chronic fistulas may necessitate additional interventions or surgery.
Background:
Silicone-covered endoluminal stents have been applied to various hollow visceral disorders in adult patients with varying success. Efficacy of retrievable endoluminal stenting in children is less well-established.
Purpose:
The purpose of this study was to evaluate our experience with evolving applications of endoluminal silicone-covered stenting in children.
Research Design:
Eight children 19 years and younger having silicone-covered stent placement for various indications at a single institution (2014-2021) were reviewed retrospectively.
Results:
Eight patients received a total of 26 silicone-covered stents. Four stent placements (15.4%) were associated with a direct adverse event. To resolve the endoluminal disorder, four patients received multiple stents or further intervention. When evaluating novel applications, clinical benefit was noted for one patient with vaginal atresia, and another after ileal pouch anal anastomosis disruption.
Conclusion:
This experience highlights the broad and innovative applications for endoluminal silicone-covered natural orifice stenting in children. Acute processes respond well and rapidly to stenting, although chronic, established fistula may require additional manipulations or surgery.
