Department of Surgery and Surgical Oncology, Helios Hospital Berlin Buch, 13122, Berlin, Germany.
Int J Colorectal Dis. 2010 Dec;25(12):1475-9. doi: 10.1007/s00384-010-1038-y. Epub 2010 Aug 25.
The application of stents in benign colorectal strictures is considered controversial. The aim of the present study was to assess effectiveness and complications associated with colorectal stent placement in benign colorectal disease.
Fourteen patients with benign colorectal strictures who had undergone previous surgery (colorectal anastomotic stenosis, 13; neosphincter scar stenosis, one) were treated with covered self-expanding metal stent or plastic stent. Placement of the stent was performed with combined endoscopy and contrast enhanced fluoroscopy.
Self-expanding stents were successful implanted in all 14 patients without acute procedure-related complications. All patients experienced immediate decompression after stent placement with expansion and patency of the stent. Relief of bowel obstruction for at least 12 months was achieved in seven of 14 patients (50%). Anastomotic fistula healed in four of six patients (67%). Despite the initial success of stenting, re-operations had to be performed in two of seven patients because of late recurrence of the stricture after a mean follow-up of 37 months.
Temporary insertion of self-expanding stents is a safe procedure that may be effective in selected cases of benign colorectal stricture. However, repeat surgery will be necessary in a considerable number of patients due to primary or secondary failure of stenting.
支架在良性结直肠狭窄中的应用存在争议。本研究旨在评估在良性结直肠疾病中放置结直肠支架的有效性和相关并发症。
14 例良性结直肠狭窄患者，既往行手术治疗（结直肠吻合口狭窄 13 例，新括约肌瘢痕狭窄 1 例），采用覆膜自膨式金属支架或塑料支架治疗。支架放置采用内镜联合增强透视。
14 例患者均成功植入自膨式支架，无急性手术相关并发症。所有患者支架放置后立即减压，支架扩张通畅。14 例患者中 7 例（50%）至少 12 个月缓解肠梗阻。6 例吻合口瘘患者中 4 例（67%）愈合。尽管支架置入术初期成功，但在平均随访 37 个月后，由于狭窄复发，7 例患者中有 2 例不得不再次手术。
自膨式支架的临时置入是一种安全的方法，在某些良性结直肠狭窄的情况下可能有效。然而，由于支架置入术的原发性或继发性失败，相当一部分患者需要再次手术。
