Gelbmann C M, Ratiu N L, Rath H C, Rogler G, Lock G, Schölmerich J, Kullmann F
Department of Internal Medicine I, University of Regensburg, Germany.
Endoscopy. 2004 Aug;36(8):695-9. doi: 10.1055/s-2004-825656.
Extensive anastomotic leaks after esophageal resection and esophageal perforations are a therapeutic challenge. The aim of the present study was to assess the potential of the self-expandable Polyflex plastic stent for the treatment of these conditions.
Between January 2002 and March 2003, nine patients were treated with a self-expandable Polyflex plastic stent for sealing of thoracic esophagoenteric anastomotic leaks following surgical resection (n = 5) or esophageal perforation (n = 4).
In all patients the stents were inserted successfully without technical problems. In all but two patients complete sealing of the leak was achieved as demonstrated by radiography with water-soluble contrast media. The stent migration rate was 30 % and repositioning of the migrated stents was possible in all cases. Complete mucosal healing of the esophageal leaks and stent extraction was achieved in six patients. The stents were in situ for an average period of 135 +/- 78 days. Two critically ill patients with anastomotic leaks died in spite of stent insertion due to sepsis and one patient with esophageal perforation died due to the underlying malignant disease.
Our preliminary experience with the self-expanding and removable Polyflex plastic stent for the sealing of anastomotic leaks and esophageal perforations suggests that this stent is a feasible treatment option, in particular, for more extensive esophageal defects, patients with co-morbid conditions, and critically ill patients.
食管切除术后广泛的吻合口漏及食管穿孔是治疗上的挑战。本研究的目的是评估可自膨胀的Polyflex塑料支架治疗这些病症的潜力。
2002年1月至2003年3月期间，9例患者接受了可自膨胀的Polyflex塑料支架治疗，用于封闭手术切除（n = 5）或食管穿孔（n = 4）后的胸段食管肠吻合口漏。
所有患者均成功置入支架，无技术问题。除2例患者外，所有患者经水溶性造影剂造影显示漏口完全封闭。支架移位率为30%，所有移位支架均能重新定位。6例患者食管漏口黏膜完全愈合并取出支架。支架平均在位时间为135±78天。2例患有吻合口漏的重症患者尽管置入了支架，但因败血症死亡，1例食管穿孔患者因潜在恶性疾病死亡。
我们使用可自膨胀且可取出的Polyflex塑料支架封闭吻合口漏及食管穿孔的初步经验表明，该支架是一种可行的治疗选择，尤其适用于更广泛的食管缺损、合并症患者及重症患者。
