Cheng Ying-Sheng, Li Ming-Hua, Chen Wei-Xiong, Chen Ni-Wei, Zhuang Qi-Xin, Shang Ke-Zhong
Department of Radiology, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
World J Gastroenterol. 2004 Jan 15;10(2):284-6. doi: 10.3748/wjg.v10.i2.284.
To observe the frequent complications of stent placement for stricture of the gastrointestinal tract and to find proper treatment.
A total number of 140 stents were inserted in 138 patients with benign stricture of the gastrointestinal tract. The procedure was completed under fluoroscopy in all of the patients.
Stents were successfully placed in all the 138 patients. Pains occurred in 23 patients (16.7%), slight or dull pains were found in 21 patients and severe chest pain in 2 respectively. For the former type of pain, the patients received only analgesia or even no treatment, while peridural anesthesia was conducted for the latter condition. Reflux occurred in 16 of these patients (11.6%) after stent placement. It was managed by common antireflux procedures. Gastrointestinal bleeding occurred in 13 patients (9.4%), and was treated by hemostat. Restenosis of the gastrointestinal tract occurred in 8 patients (5.8%), and was apparently associated with hyperplasia of granulation tissue. In 2 patients, the second stent was placed under X-ray guidance. The granulation tissue was removed by cauterization through hot-node therapy under gastroscope guidance in 3 patients, and surgical reconstruction was performed in another 3 patients. Stent migration occurred in 5 patients (3.6%), and were extracted with the aid of a gastroscope. Food-bolus obstruction was encountered in 2 patients (1.4%) and was treated by endoscope removal. No perforation occurred in all patients.
Frequent complications after stent placement for benign stricture of the gastrointestinal tract include pain, reflux, bleeding, restenosis, stent migration and food-bolus obstruction. They can be treated by drugs, the second stent placement or gastroscopic procedures according to the specific conditions.
观察胃肠道狭窄支架置入术的常见并发症并寻找合适的治疗方法。
138例胃肠道良性狭窄患者共置入140枚支架。所有患者均在透视下完成手术。
138例患者支架均成功置入。23例患者（16.7%）出现疼痛，其中21例为轻微或隐痛，2例为严重胸痛。对于前一种疼痛类型，患者仅接受镇痛治疗甚至无需治疗，而对于后一种情况则进行了硬膜外麻醉。16例患者（11.6%）支架置入后出现反流，通过常规抗反流措施进行处理。13例患者（9.4%）发生胃肠道出血，采用止血剂治疗。8例患者（5.8%）出现胃肠道再狭窄，明显与肉芽组织增生有关。2例患者在X线引导下置入了第二枚支架。3例患者在胃镜引导下通过热活检钳烧灼去除肉芽组织，另3例患者进行了手术重建。5例患者（3.6%）发生支架移位，借助胃镜取出。2例患者（1.4%）出现食物团块梗阻，通过内镜取出进行治疗。所有患者均未发生穿孔。
胃肠道良性狭窄支架置入术后常见并发症包括疼痛、反流、出血、再狭窄、支架移位和食物团块梗阻。可根据具体情况通过药物、置入第二枚支架或胃镜操作进行治疗。
