Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Gastrointest Endosc. 2013 Jan;77(1):18-28. doi: 10.1016/j.gie.2012.09.001.
Temporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases.
To evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases.
Multicenter retrospective study.
Six tertiary care centers in the United States and Europe.
A total of 214 patients with benign esophageal diseases undergoing endoscopic stent removal.
Endoscopic stent removal.
Endoscopic techniques for stent removal, time to stent removal, and adverse events related to stent removal.
A total of 214 patients underwent a total of 329 stent extractions. Stents were mainly placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents, 52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic stents. A total of 35 (10.6%) procedure-related adverse events were reported, including 7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs (P < .001) was a risk factor for adverse events during stent removal. Favorable factors for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194).
Retrospective analysis, only tertiary care centers.
With an acceptable major adverse event rate of 2.1%, esophageal stent removal in the setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse events caused by stent removal were not time dependent.
自膨式支架的临时放置已越来越多地用于治疗良性食管疾病。
评估内镜下切除用于治疗良性食管疾病的自膨式食管支架的安全性。
多中心回顾性研究。
美国和欧洲的 6 家三级护理中心。
214 名良性食管疾病患者行内镜下支架取出术。
内镜下支架取出术。
支架取出的内镜技术、支架取出时间和与支架取出相关的不良事件。
共 214 例患者共进行了 329 次支架取出术。放置支架主要是为了治疗难治性狭窄（49.2%）和瘘管（49.8%）。取出的支架中，52%为完全覆膜自膨式金属支架（FCSEMSs），28.6%为部分覆膜自膨式金属支架（PCSEMSs），19.5%为自膨式塑料支架。共报告了 35 例（10.6%）与操作相关的不良事件，包括 7 例（2.1%）严重不良事件。多变量分析显示，使用 PCSEMSs（P<.001）是支架取出过程中发生不良事件的危险因素。支架成功取出的有利因素是 FCSEMSs（P≤.012）和支架迁移（P=.010）。支架留置时间（P=.145）和支架嵌入（P=.194）与不良事件无显著相关性。
回顾性分析，仅为三级护理中心。
良性疾病中，食管支架取出术的主要不良事件发生率为 2.1%，是一种安全可行的方法。FCSEMSs 比自膨式塑料支架和 PCSEMSs 更容易取出。支架取出引起的不良事件与时间无关。
