Department of Thoracic Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou, People's Republic of China.
Dysphagia. 2012 Jun;27(2):260-4. doi: 10.1007/s00455-011-9361-1. Epub 2011 Aug 9.
The use of metal stents for malignant esophageal strictures for palliation is well accepted. However, utilization of metal stents for benign esophageal diseases has been controversial. Given the availability of removable, fully covered, self-expandable metal stents (RFCSEMSs), this study was undertaken to evaluate the effectiveness and safety of RFCSEMSs in patients with refractory benign esophagogastric anastomotic strictures. Twenty-four patients with RFCSEMSs were enrolled in this study. All patients had undergone endoscopic Savary-Gilliard bougie dilatation five times or more but there was no significant improvement in symptoms. For all 24 patients, the symptom of dysphagia was alleviated significantly while the stent was in place and for a short time after stent removal, and dysphagia scores decreased from 3-4 to 0-1. After 12 months of follow-up, 18 patients were free from dysphagia but the other 6 patients still suffered obvious dysphagia. RFCSEMSs are still not perfect and can induce some complications. The treatment failure rate of restenting was remarkably high after the first failure. Given that effective methods for treating refractory stricture have not been found, RFCSEMSs could be considered for treating refractory benign esophagogastric anastomotic stricture.
金属支架被广泛用于恶性食管狭窄的姑息性治疗。然而，金属支架在良性食管疾病中的应用一直存在争议。鉴于可取出的全覆膜自膨式金属支架（RFCSEMS）的可用性，本研究旨在评估 RFCSEMS 在难治性良性食管胃吻合口狭窄患者中的有效性和安全性。本研究纳入了 24 例接受 RFCSEMS 治疗的患者。所有患者均接受过内镜下 Savary-Gilliard 探条扩张 5 次或以上，但症状无明显改善。对于所有 24 例患者，支架在位时以及支架取出后短时间内，吞咽困难症状均得到显著缓解，吞咽困难评分从 3-4 分降至 0-1 分。随访 12 个月后，18 例患者无吞咽困难，但仍有 6 例患者有明显吞咽困难。RFCSEMS 并不完美，可引起一些并发症。首次失败后再次支架置入的治疗失败率很高。鉴于尚未找到治疗难治性狭窄的有效方法，可考虑将 RFCSEMS 用于治疗难治性良性食管胃吻合口狭窄。
