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 Feb 1;10(3):410-4. doi: 10.3748/wjg.v10.i3.410.
To determine the most effective intervention procedure by evaluation of mid and long-term therapeutic efficacy in patients of stricture of the gastrointestinal tract (GIT).
Different intervention procedures were used to treat benign stricture of GIT in 180 patients including pneumatic dilation (group A, n=80), permanent (group B, n=25) and temporary (group C, n=75) placement of expandable metallic stents.
The diameters of the strictured GIT were significantly greater after the treatment of all procedures employed (P<0.01). For the 80 patients in group A, 160 dilations were performed (mean, 2.0 times per patient). Complications in group A included chest pain (n=20), reflux (n=16), and bleeding (n=6). Dysphagia relapse occurred in 24 (30%) and 48 (60%) patients respectively during 6-and-12 month follow-up periods in group A. In group B, 25 uncovered or partially covered or antireflux covered expandable metallic stents were placed permanently, complications included chest pain (n=10), reflux (n=15), bleeding (n=3), and stent migration (n=4), and dysphagia relapse occurred in 5 (20%) and 3 patients (25%) during the 6-and-12 month follow-up periods, respectively. In group C, the partially covered expandable metallic stents were temporarily placed in 75 patients and removed after 3 to 7 days via gastroscope, complications including chest pain (n=30), reflux (n=9), and bleeding (n=12), and dysphagia relapse occurred in 9 (12%) and 8 patients (16%) during the 6-and-12 month follow-up periods, respectively. The placement and withdrawal of stents were all successfully performed. The follow-up of all patients lasted for 6 to 96 months (mean 45.3+/-18.6 months).
The effective procedures for benign GIT stricture are pneumatic dilation and temporary placement of partially-covered expandable metallic stents. Temporary placement of partially-covered expandable metallic stents is one of the best methods for benign GIT strictures in mid and long-term therapeutic efficacy.
通过评估胃肠道（GIT）狭窄患者的中长期治疗效果，确定最有效的干预程序。
采用不同的干预程序治疗180例GIT良性狭窄患者，包括气囊扩张术（A组，n = 80）、永久性（B组，n = 25）和临时性（C组，n = 75）置入可扩张金属支架。
采用的所有治疗程序治疗后，GIT狭窄部位的直径均显著增大（P < 0.01）。A组80例患者共进行了160次扩张（平均每位患者2.0次）。A组的并发症包括胸痛（n = 20）、反流（n = 16）和出血（n = 6）。在A组6个月和12个月的随访期内，分别有24例（30%）和48例（60%）患者吞咽困难复发。B组永久性置入25枚未覆盖、部分覆盖或抗反流覆盖的可扩张金属支架，并发症包括胸痛（n = 10）、反流（n = 15）、出血（n = 3）和支架移位（n = 4），在6个月和12个月的随访期内，分别有5例（20%）和3例（25%）患者吞咽困难复发。C组75例患者临时性置入部分覆盖的可扩张金属支架，3至7天后通过胃镜取出，并发症包括胸痛（n = 30）、反流（n = 9）和出血（n = 12），在6个月和12个月的随访期内，分别有9例（12%）和8例（16%）患者吞咽困难复发。支架的置入和取出均成功完成。所有患者的随访时间为6至96个月（平均45.3±18.6个月）。
GIT良性狭窄的有效治疗程序是气囊扩张术和临时性置入部分覆盖的可扩张金属支架。临时性置入部分覆盖的可扩张金属支架是中长期治疗GIT良性狭窄的最佳方法之一。
