Division of Gastroenterology, University of Florida, 1600 SW Archer Road, HD 602, Gainesville, FL 32610, USA.
Dig Dis Sci. 2010 Dec;55(12):3399-403. doi: 10.1007/s10620-010-1415-y. Epub 2010 Sep 23.
Expandable esophageal stents are widely used for the palliation of dysphagia in patients with esophageal cancer and are also beginning to be used in patients with benign esophageal diseases such as refractory strictures and fistulas. There is concern regarding the increased risk of migration of the fully covered Alimaxx metal esophageal stent and experience with this stent in benign esophageal pathology has been reported in only a small series of patients.
To evaluate the technical success in placement and removal, efficacy and complications of the Alimaxx esophageal stent for benign esophageal diseases.
Our endoscopy database was retrospectively reviewed from 1/2003 to 2/2009 to identify patients with Alimaxx esophageal stent placement for benign diseases. Chart review was performed for age, gender, indication, site of the lesion, success of placement, outcome, and incidence of complications.
Twenty-eight stents were successfully placed in 14 patients with benign esophageal diseases (mean: two stents/patient; range 1-7). Indications included esophageal fistula in seven (50%) and benign strictures in 7/14 (50%). Dysphagia improved in all patients while the fistula resolved in 6/7 (85.8%) patients. Complications related to stents included pain (2/28, 7%), stent related gastric ulcer (1/28, 4%), nausea and vomiting (3/21, 11%) and stent migration (11/28, 39%). All migrated stents were successfully endoscopically retrieved.
The fully covered and removable Alimaxx stent is effective in the endoscopic management of benign esophageal strictures or fistulas, despite its relatively high rate of migration. Stent migration was successfully managed endoscopically without complications.
可扩张食管支架广泛用于缓解食管癌患者的吞咽困难,也开始用于良性食管疾病,如难治性狭窄和瘘管。人们担心完全覆盖的 Alimaxx 金属食管支架的迁移风险增加,并且仅在少数良性食管病理患者的小系列中报告了该支架的使用经验。
评估 Alimaxx 食管支架用于良性食管疾病的放置和取出的技术成功率、疗效和并发症。
我们的内镜数据库从 2003 年 1 月至 2009 年 2 月进行了回顾性分析,以确定 Alimaxx 食管支架放置用于良性疾病的患者。对年龄、性别、适应证、病变部位、放置成功率、结果和并发症发生率进行了图表回顾。
14 例良性食管疾病患者共成功放置了 28 个支架(平均:每个患者 2 个支架;范围 1-7)。适应证包括食管瘘 7 例(50%)和良性狭窄 7/14 例(50%)。所有患者的吞咽困难均得到改善,而瘘管在 6/7 例(85.8%)患者中得到缓解。与支架相关的并发症包括疼痛(2/28,7%)、支架相关胃溃疡(1/28,4%)、恶心和呕吐(3/21,11%)和支架迁移(11/28,39%)。所有迁移的支架均成功通过内镜取出。
尽管完全覆盖和可移除的 Alimaxx 支架的迁移率相对较高,但在良性食管狭窄或瘘管的内镜管理中仍然有效。支架迁移成功通过内镜管理,无并发症。