全覆膜金属可回收支架在治疗食管顽固性良性狭窄中的应用价值

Evaluation of removable, fully covered, self- expandable metal stents for the treatment of refractory benign esophageal strictures

摘要:

摘要：目的 探讨全覆膜金属可回收支架治疗食管顽固性良性狭窄的安全性及疗效。方法 回顾性分析行全覆膜金属可回收支架治疗的33例食管顽固性良性狭窄患者的临床资料，评价治疗的可行性、安全性及疗效。结果 33例患者共计放置可回收支架41支，其中8例患者行二次可回收支架置入，术后均有不同程度胸痛及异物感；术后并发支架移位11例（共计14支），移位发生率34.1%（14/41）；其余22例患者（共计27支支架）均于术后4～8周顺利回收。术中及术后无明显出血、穿孔等并发症发生，无支架相关死亡病例。所有患者定期参加随访（>12个月），其中12例成功解除梗阻，临床缓解率为36.4%（12/33）。结论 全覆膜金属可回收支架用于治疗食管顽固性良性狭窄是安全可靠的，可使部分患者成功解除梗阻，但支架移位发生率高，有待于临床进一步研究解决。

Abstract:

Abstract: Objective To assess the safety and effectiveness of removable, fully covered, self-expandable metal stents in patients with refractory benign esophageal strictures. Methods The date of 33 patients with refractory benign esophageal strictures treated with removable, fully covered, self-expandable metal stents were retrospected. Feasibility, safety and effects were evaluated accordingly. Results Thirty-three patients underwent esophageal stent placement for refractory benign esophageal strictures, with a total of 41 stents were placed. 8 out of 33 patients underwent a second stent placement. All of the patients experienced different levels of chest pain and foreign body sensation after stent placement. Stents migration were observed in 11 patients (with a total of 14 stents), the migration rate was 34.1% (14/41). The other 22 patients with a total of 27 stents were removed within 4 ~ 8 weeks after placement. No obvious bleeding or esophageal rupture was found during stent placement or stent removal. None of patients died with stent placement. All of the patients were followed up regularly after stent removal (>12 months), 12 out of 33 patients were free from dysphagia, the stricture resolution rate was 36.4% (12/33). Conclusion Use of removable, fully covered, self-expandable metal stents seem to be a safe and reliable method of treatment in patients with refractory benign esophageal strictures. It can make some patients were successfully free from dysphagia, but have a high incidence of stents migration, so the further research will be necessary to solve this problem.