Esophageal self-expandable metallic stents (SEMS): Results of a national survey regarding practice and techniques

B. Dennert, S. T. Zierer, Francisco C Ramirez

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

SEMS have changed the management of malignant dysphagia. The magnitude of SEMS use in the community, and the clinical outcomes is unknown. Objective: To determine the reasons for SEMS selection and practice techniques for their placement in the gastroenterology community. Material and Methods: A survey was mailed to members of the ASGE. Results: Of 3414 surveys mailed, only 212 responded (6.2%) 128 physicians had experience with the placement of SEMS (60%) and the remaining 84 (40%) did not. Self-reported practice settings for the users were: private 72%, academic 24%. and VAMC 4%. These figures did not differ from the non-user group. A total of 434 SEMS were placed. 75% of users had placed ≤ 3 SEMS. Dilation before SEMS Guidance for Deployment OTW TTS Endosc (E) alone Fluorosc(F) alone E+F 83 (65%) 40 (31%) 2 (2%) 19 (15%) 106 (83%) Verification Patency/Position Scope Thru SEMS Immed X-ray Ba Sw same day Ba Sw next day 78 (61%) 46 (36%) 14 (11%) 24 (19%) Patients were discharged home the same day by 20%, and the next day by 36% of respondents. The choice of SEMS was based on: perceived ease of placement 71 (55%); availability for coated form 62 (48%); availability of desired length 36 (28%); documented efficacy in clinical studies 27 (21%); company advertisement 23 (18%); advise from fellow physician 22 (17%); cost difference 20 (16%); negative past experience 16 (12.5%); perceived difference m stent strength II (8.6%). The SEMS chosen were: Ultraflex: 184 (42%); Wallstent: 183 (42%); Gianturco: 40 (9%); Endocoil 25 (6%). Forty-six percent (59) physicians considered the placement of SEMS as the first line therapy for dysphagia in unresectable malignancy. Conclusions: SEMS are increasingly being placed as a first line therapy for malignant dysphagia. Self reported techniques and stent choices vary widely Practice guidelines on the use of SEMS may be helpful.

Original languageEnglish (US)
Pages (from-to)333
Number of pages1
JournalGastrointestinal Endoscopy
Volume43
Issue number4
StatePublished - 1996
Externally publishedYes

Fingerprint

Deglutition Disorders
Physicians
Surveys and Questionnaires
Self Expandable Metallic Stents
Stents
Gastroenterology
Practice Guidelines
Dilatation
X-Rays
Costs and Cost Analysis
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Esophageal self-expandable metallic stents (SEMS) : Results of a national survey regarding practice and techniques. / Dennert, B.; Zierer, S. T.; Ramirez, Francisco C.

In: Gastrointestinal Endoscopy, Vol. 43, No. 4, 1996, p. 333.

Research output: Contribution to journalArticle

@article{fec49586e7ad4639b215e42d5b723d0f,
title = "Esophageal self-expandable metallic stents (SEMS): Results of a national survey regarding practice and techniques",
abstract = "SEMS have changed the management of malignant dysphagia. The magnitude of SEMS use in the community, and the clinical outcomes is unknown. Objective: To determine the reasons for SEMS selection and practice techniques for their placement in the gastroenterology community. Material and Methods: A survey was mailed to members of the ASGE. Results: Of 3414 surveys mailed, only 212 responded (6.2{\%}) 128 physicians had experience with the placement of SEMS (60{\%}) and the remaining 84 (40{\%}) did not. Self-reported practice settings for the users were: private 72{\%}, academic 24{\%}. and VAMC 4{\%}. These figures did not differ from the non-user group. A total of 434 SEMS were placed. 75{\%} of users had placed ≤ 3 SEMS. Dilation before SEMS Guidance for Deployment OTW TTS Endosc (E) alone Fluorosc(F) alone E+F 83 (65{\%}) 40 (31{\%}) 2 (2{\%}) 19 (15{\%}) 106 (83{\%}) Verification Patency/Position Scope Thru SEMS Immed X-ray Ba Sw same day Ba Sw next day 78 (61{\%}) 46 (36{\%}) 14 (11{\%}) 24 (19{\%}) Patients were discharged home the same day by 20{\%}, and the next day by 36{\%} of respondents. The choice of SEMS was based on: perceived ease of placement 71 (55{\%}); availability for coated form 62 (48{\%}); availability of desired length 36 (28{\%}); documented efficacy in clinical studies 27 (21{\%}); company advertisement 23 (18{\%}); advise from fellow physician 22 (17{\%}); cost difference 20 (16{\%}); negative past experience 16 (12.5{\%}); perceived difference m stent strength II (8.6{\%}). The SEMS chosen were: Ultraflex: 184 (42{\%}); Wallstent: 183 (42{\%}); Gianturco: 40 (9{\%}); Endocoil 25 (6{\%}). Forty-six percent (59) physicians considered the placement of SEMS as the first line therapy for dysphagia in unresectable malignancy. Conclusions: SEMS are increasingly being placed as a first line therapy for malignant dysphagia. Self reported techniques and stent choices vary widely Practice guidelines on the use of SEMS may be helpful.",
author = "B. Dennert and Zierer, {S. T.} and Ramirez, {Francisco C}",
year = "1996",
language = "English (US)",
volume = "43",
pages = "333",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Esophageal self-expandable metallic stents (SEMS)

T2 - Results of a national survey regarding practice and techniques

AU - Dennert, B.

AU - Zierer, S. T.

AU - Ramirez, Francisco C

PY - 1996

Y1 - 1996

N2 - SEMS have changed the management of malignant dysphagia. The magnitude of SEMS use in the community, and the clinical outcomes is unknown. Objective: To determine the reasons for SEMS selection and practice techniques for their placement in the gastroenterology community. Material and Methods: A survey was mailed to members of the ASGE. Results: Of 3414 surveys mailed, only 212 responded (6.2%) 128 physicians had experience with the placement of SEMS (60%) and the remaining 84 (40%) did not. Self-reported practice settings for the users were: private 72%, academic 24%. and VAMC 4%. These figures did not differ from the non-user group. A total of 434 SEMS were placed. 75% of users had placed ≤ 3 SEMS. Dilation before SEMS Guidance for Deployment OTW TTS Endosc (E) alone Fluorosc(F) alone E+F 83 (65%) 40 (31%) 2 (2%) 19 (15%) 106 (83%) Verification Patency/Position Scope Thru SEMS Immed X-ray Ba Sw same day Ba Sw next day 78 (61%) 46 (36%) 14 (11%) 24 (19%) Patients were discharged home the same day by 20%, and the next day by 36% of respondents. The choice of SEMS was based on: perceived ease of placement 71 (55%); availability for coated form 62 (48%); availability of desired length 36 (28%); documented efficacy in clinical studies 27 (21%); company advertisement 23 (18%); advise from fellow physician 22 (17%); cost difference 20 (16%); negative past experience 16 (12.5%); perceived difference m stent strength II (8.6%). The SEMS chosen were: Ultraflex: 184 (42%); Wallstent: 183 (42%); Gianturco: 40 (9%); Endocoil 25 (6%). Forty-six percent (59) physicians considered the placement of SEMS as the first line therapy for dysphagia in unresectable malignancy. Conclusions: SEMS are increasingly being placed as a first line therapy for malignant dysphagia. Self reported techniques and stent choices vary widely Practice guidelines on the use of SEMS may be helpful.

AB - SEMS have changed the management of malignant dysphagia. The magnitude of SEMS use in the community, and the clinical outcomes is unknown. Objective: To determine the reasons for SEMS selection and practice techniques for their placement in the gastroenterology community. Material and Methods: A survey was mailed to members of the ASGE. Results: Of 3414 surveys mailed, only 212 responded (6.2%) 128 physicians had experience with the placement of SEMS (60%) and the remaining 84 (40%) did not. Self-reported practice settings for the users were: private 72%, academic 24%. and VAMC 4%. These figures did not differ from the non-user group. A total of 434 SEMS were placed. 75% of users had placed ≤ 3 SEMS. Dilation before SEMS Guidance for Deployment OTW TTS Endosc (E) alone Fluorosc(F) alone E+F 83 (65%) 40 (31%) 2 (2%) 19 (15%) 106 (83%) Verification Patency/Position Scope Thru SEMS Immed X-ray Ba Sw same day Ba Sw next day 78 (61%) 46 (36%) 14 (11%) 24 (19%) Patients were discharged home the same day by 20%, and the next day by 36% of respondents. The choice of SEMS was based on: perceived ease of placement 71 (55%); availability for coated form 62 (48%); availability of desired length 36 (28%); documented efficacy in clinical studies 27 (21%); company advertisement 23 (18%); advise from fellow physician 22 (17%); cost difference 20 (16%); negative past experience 16 (12.5%); perceived difference m stent strength II (8.6%). The SEMS chosen were: Ultraflex: 184 (42%); Wallstent: 183 (42%); Gianturco: 40 (9%); Endocoil 25 (6%). Forty-six percent (59) physicians considered the placement of SEMS as the first line therapy for dysphagia in unresectable malignancy. Conclusions: SEMS are increasingly being placed as a first line therapy for malignant dysphagia. Self reported techniques and stent choices vary widely Practice guidelines on the use of SEMS may be helpful.

UR - http://www.scopus.com/inward/record.url?scp=10544237093&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10544237093&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:10544237093

VL - 43

SP - 333

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 4

ER -