Endoscopic Treatment with the Use of Silicone Covered Self Expanding Polyester Stents in Esophageal Leaks, Strictures, and Fistulae

90%; upper oesophagus (34%), mid-oesophagus (20%), lower oesophagus (30%) and stomach (6%). The initial endoscopic procedure failed to remove the foreign body in 20 patients (15%); flexible 16% (n Z 15), rigid 14% (n Z 5). Overall, failure rates were similar by site of impaction, but flexible endoscopy was more likely to fail in the upper oesophagus and rigid in the lower oesophagus. Retrieval of meat was associated with higher failure rates. Method of removal was documented in 86% (31% push, 41% pull and 14% combined). The push technique had a lower failure rate, complication rates were comparable. Overall complications were seen in 4 patients (3%). Excluding mucosal tears and oesophagitis, 22 patients had new diagnoses made on initial endoscopy and 7 patients on follow-up. Compliance with follow up investigations was poor. 2 patients (1.5%) underwent immediate therapeutic dilatation. Conclusion: Flexible and rigid endoscopy are equally effective with low complication rates. The push technique is validated as a safe method of removal. Follow-up investigations provide a small number of additional diagnoses but given the poor compliance rate we should consider undertaking all diagnostic and therapeutic interventions at initial endoscopy.