Martins Bruno da Costa, Retes Felipe Alves, Medrado Bruno Frederico, de Lima Marcelo Simas, Pennacchi Caterina Maria Pia Simione, Kawaguti Fabio Shiguehissa, Safatle-Ribeiro Adriana Vaz, Uemura Ricardo Sato, Maluf-Filho Fauze
Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil.
World J Gastrointest Endosc. 2014 Feb 16;6(2):49-54. doi: 10.4253/wjge.v6.i2.49.
The use of self-expandable metallic stents has increased recently to palliate inoperable esophageal neoplasia and also in the management of benign strictures. Migration is one of the most common complications after stent placement and the endoscopist should be able to recognize and manage this situation. Several techniques for managing migrated stents have been described, as well as new techniques for preventing stent migration. Most stents have a "lasso" at the upper flange which facilitates stent repositioning or removal. An overtube, endoloop and large polypectomy snare may be useful for the retrieval of stents migrated into the stomach. External fixation of the stent with Shim's technique is efficient in preventing stent migration. Suturing the stent to the esophageal wall, new stent designs with larger flanges and double-layered stents are promising techniques to prevent stent migration but they warrant validation in a larger cohort of patients.
近年来，自膨式金属支架的使用有所增加，用于缓解无法手术的食管肿瘤以及良性狭窄的治疗。支架移位是支架置入后最常见的并发症之一，内镜医师应能够识别并处理这种情况。已描述了多种处理移位支架的技术以及预防支架移位的新技术。大多数支架在上端有一个“套索”，便于支架重新定位或取出。外套管、内镜圈套器和大型息肉切除圈套器可能有助于取出移入胃内的支架。采用沈氏技术对支架进行外部固定可有效防止支架移位。将支架缝合至食管壁、设计有更大侧翼的新型支架以及双层支架是预防支架移位的有前景的技术，但需要在更多患者队列中进行验证。
