Gui-Yong Peng, Xiu-Feng Kang, Xin Lu, Lei Chen, Qian Zhou, Department of Gastroenterology of Southwest Hospital, The Third Military Medical University, Chongqing 400038, China.
World J Gastroenterol. 2013 Oct 14;19(38):6505-8. doi: 10.3748/wjg.v19.i38.6505.
A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy. The gastroscope was guided into the esophagus through the ST-E tube, and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope. Under gastroscopy, the stent wire was grasped with the forceps and pulled into the ST-E tube. When resistance was met during withdrawal, the gastroscope was guided further to the esophageal section where the stent was embedded. Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh. While the lower section of the Z-shaped stent was fixed by the biopsy forceps, the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated. The wire mesh of the stent was then removed in stages through the ST-E tube. Care was taken to avoid bleeding and perforation. Under the assistance of an ST-E plastic tube, an embedded esophageal metal stent was successfully removed with no bleeding or perforation. The patient experienced an uneventful recovery after surgery. Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive, safe, and effective.
一位患者因食管气管瘘放置食管支架后出现支架嵌入，采用经胃镜将 ST-E 塑料管插入食管至支架上端进行治疗。通过 ST-E 管引导胃镜进入食管，通过胃镜旁的 ST-E 管插入鳄鱼夹进入食管。在胃镜下，用钳子夹住支架丝并拉入 ST-E 管。在退出时遇到阻力时，引导胃镜进一步进入支架嵌入的食管段。通过胃镜上的活检孔引导活检钳到达嵌入的支架，以去除硅酮膜和连接 Z 形金属网的连接线。当 Z 形支架的下段被活检钳固定时，用鳄鱼夹夹住金属丝的上段，直到 Z 形金属环拉长。然后通过 ST-E 管逐步取出支架的金属网。注意避免出血和穿孔。在 ST-E 塑料管的辅助下，成功地取出了嵌入的食管金属支架，没有出血或穿孔。患者术后恢复顺利。塑料管辅助胃镜下取出嵌入的金属支架具有微创、安全、有效的特点。
