Ko Heung-Kyu, Song Ho-Young, Shin Ji Hoon, Lee Gin Hyug, Jung Hwoong-Yong, Park Seung-Il
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea.
J Vasc Interv Radiol. 2007 Jun;18(6):725-32. doi: 10.1016/j.jvir.2007.02.030.
To investigate the frequency of esophageal and gastroduodenal stent migration and the fate of such stents.
The authors studied five types of covered metal stents. Type A stents were nonretrievable polyurethane-covered stents with shouldered ends (n = 169), type B stents were retrievable polyurethane-covered stents with shouldered ends (n = 62), type C stents were retrievable polyurethane-covered stents with flared ends (n = 72), type D stents were retrievable polytetrafluoroethylene-covered stents with shouldered ends (n = 369), and type E stents were separated stents (n = 216). Types A-D stents were esophageal stents, and the type E stent was a gastroduodenal stent. Stents were placed in 888 patients with either benign (n = 43) or malignant (n = 845) causes of stricture. The rate of stent migration was analyzed relative to completeness of migration, the cause of obstruction, stent type, and stent placement location. The fate of migrated stents and the treatment of patients were evaluated.
Stent migration occurred in 70 of the 888 patients (7.9%). Migration occurred in 11 of the 43 patients (25%) with benign cause of strictures and 591 of the 845 patients (7.0%) with malignant cause. The migration rates for types A, B, C, D, and E stents were 10%, 4.8%, 24%, 7.3% and 2.8%, respectively. Of the 70 migrated stents, 45 had complete migration and 25 had partial migration. The anastomotic sites were the areas most commonly associated with migration (16%), but this was not statistically significant. Forty of the 70 migrated stents were removed with retrieval devices under fluoroscopic guidance because they were not passed with stool and possibility of complications related to migrated stents. The remaining 30 stents exited via the rectum (n = 15), remained in the body without complications (n = 12), or were surgically removed because they caused complicated intestinal obstructions (n = 3).
The overall migration rate for esophageal and gastroduodenal stents was 7.9%. Most migrated stents were removed nonsurgically, exited the body spontaneously, or remained in the body in an uncomplicated state. Surgical stent removal was necessary in three patients (4.3%) due to complicated intestinal obstructions.
研究食管和胃十二指肠支架移位的频率及此类支架的转归情况。
作者研究了五种类型的覆膜金属支架。A型支架为不可回收的带肩部末端的聚氨酯覆膜支架（n = 169），B型支架为可回收的带肩部末端的聚氨酯覆膜支架（n = 62），C型支架为可回收的带喇叭口末端的聚氨酯覆膜支架（n = 72），D型支架为可回收的带肩部末端的聚四氟乙烯覆膜支架（n = 369），E型支架为分体式支架（n = 216）。A - D型支架为食管支架，E型支架为胃十二指肠支架。支架置入888例因良性（n = 43）或恶性（n = 845）原因导致狭窄的患者体内。分析支架移位率与移位完整性、梗阻原因、支架类型及支架置入位置的关系。评估移位支架的转归及患者的治疗情况。
888例患者中有70例（7.9%）发生支架移位。43例良性狭窄患者中有11例（25%）发生移位，845例恶性狭窄患者中有59例（7.0%）发生移位。A、B、C、D、E型支架的移位率分别为10%、4.8%、24%、7.3%和2.8%。70例移位支架中，45例完全移位，25例部分移位。吻合部位是最常与移位相关的区域（16%），但无统计学意义。70例移位支架中有40例在透视引导下用回收装置取出，因为它们未随粪便排出且存在与移位支架相关的并发症风险。其余30例支架经直肠排出（n = 15）、留在体内无并发症（n = 12）或因导致复杂肠梗阻而手术取出（n = 3）。
食管和胃十二指肠支架的总体移位率为7.9%。大多数移位支架通过非手术方式取出、自行排出体外或留在体内且无并发症。因复杂肠梗阻，3例患者（4.3%）需要手术取出支架。
