García-Cano Jesús
Department of Digestive Diseases, Hospital Virgen de la Luz, C/ Federico Mayor Zaragoza, 2, 50, Cuenca 16002, Spain.
Dig Dis Sci. 2008 Feb;53(2):341-6. doi: 10.1007/s10620-007-9864-7. Epub 2007 Jun 13.
Polyflex, a new self-expanding plastic stent (SEPS), is increasingly used to treat obstructions in the gastrointestinal tract. The majority of reports on Polyflex come from tertiary referral centers. This retrospective study describes the efficacy and safety of this new SEPS for the treatment of benign strictures in esophagus and colon and its use in a community hospital. Seven patients were treated from August 2003 through December 2006. All of them presented with severe strictures, and were treated with Polyflex insertion. Four patients had esophageal obstructions (three peptic, one postoperative) and the remaining three patients had postoperative strictures in the rectosigmoid. One patient had a coexisting fistula. Two strictures (one esophageal and another colonic, both postoperative) received the Polyflex as the first line of treatment, without previous sessions of dilation. Esophageal strictures were solved after several consecutive SEPS insertions. Migrated stents were easily extracted from the stomach. On the other hand, colonic strictures achieved permanent dilation with a single stent. The patient with coexisting stricture and fistula became asymptomatic and still had the SEPS in place after four months. The one complication was mild pain after insertion. Polyflex seems to be a useful tool in the dilation of severe benign strictures in esophagus and rectosigmoid and, as in large centers, good results are achieved in a community hospital.
Polyflex是一种新型自膨式塑料支架(SEPS),越来越多地用于治疗胃肠道梗阻。关于Polyflex的大多数报告来自三级转诊中心。这项回顾性研究描述了这种新型SEPS治疗食管和结肠良性狭窄的疗效和安全性及其在社区医院的应用。2003年8月至2006年12月期间对7例患者进行了治疗。所有患者均表现为严重狭窄,并接受了Polyflex置入治疗。4例患者有食管梗阻(3例为消化性,1例为术后),其余3例患者在直肠乙状结肠处有术后狭窄。1例患者并存瘘管。2例狭窄(1例食管狭窄和1例结肠狭窄,均为术后)首次接受Polyflex治疗,未进行过扩张治疗。连续多次置入SEPS后食管狭窄得到解决。移位的支架很容易从胃中取出。另一方面,结肠狭窄通过单个支架实现了永久性扩张。并存狭窄和瘘管的患者无症状,4个月后仍保留SEPS。唯一的并发症是置入后轻度疼痛。Polyflex似乎是扩张食管和直肠乙状结肠严重良性狭窄的有用工具,与大型中心一样,在社区医院也取得了良好的效果。