Distally migrated esophageal self-expanding metal stents: wait and see or remove?

Background: Extraction of a migrated esophageal stent may be extremely difficult with a substantial risk of complications including esophageal perforation and hemorrhage. Methods: Retrospectively 242 patients were evaluated who underwent implantation of self-expanding metal stents (SEMS) and 13 (5.4%) were identified with distal stent migration. In all cases of stent dislocation into the stomach, extraction of the stent was not attempted and a new stent was inserted. Results: Twelve patients had dysphagia. One patient underwent surgery because of stent impaction in the colon, 3 had unrecognized passage of the stent per rectum, and 9 had evidence of the stent into the stomach. Further severe complications were not observed in any patient and all stents remained into the stomach. Conclusion: Complications arising from migrated esophageal stents are uncommon. Further studies are warranted to determine which patients with migrated SEMS warrant stent retrieval.