Liu Jin, Shang Liang, Liu Ji-Yong, Qin Cheng-Yong
Jin Liu, Ji-Yong Liu, Cheng-Yong Qin, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
World J Gastroenterol. 2015 Jul 28;21(28):8629-35. doi: 10.3748/wjg.v21.i28.8629.
To investigate a newly designed stent and its dilatation effect in a rabbit model of benign esophageal stricture.
Thirty-four New Zealand white rabbits underwent a corrosive injury in the middle esophagus for esophageal stricture formation. Thirty rabbits with a successful formation of esophageal strictures were randomly allocated into two groups. The control group (n = 15) was implanted with a conventional stent, and the study group (n = 15) was implanted with a detachable "pieced" stent. The study stent (30 mm in length, 10 mm in diameter) was composed of three covered metallic pieces connected by surgical suture lines. The stent was collapsed by pulling the suture lines out of the mesh. Two weeks after stricture formation, endoscopic placement of a conventional stent or the new stent was performed. Endoscopic extraction was carried out four weeks later. The extraction rate, ease of extraction, migration, complications, and survival were evaluated.
Stent migration occurred in 3/15 (20%) animals in the control group and 2/15 (13%) animals in the study group; the difference between the two groups was not statistically significant. At the end of four weeks, the remaining stents were successfully extracted with the endoscope in 100% (11/11) of the animals in the study group, and 60% (6/10) of the animals in the control group; this difference was statistically significant (P < 0.05). There was no difference in the mean number of follow-up days between the control and study groups (25.33 vs 25.85). Minor bleeding was reported in five cases in the study group and four in the control group. There were no severe complications directly associated with stent implantation or extraction in either of the two groups.
In this experimental protocol of benign esophageal strictures, the novel "pieced" stent demonstrated a superior removal rate with a similar migration rate compared to a conventional stent.
在兔良性食管狭窄模型中研究一种新设计的支架及其扩张效果。
34只新西兰白兔在食管中段进行腐蚀性损伤以形成食管狭窄。30只成功形成食管狭窄的兔子被随机分为两组。对照组(n = 15)植入传统支架,研究组(n = 15)植入可拆解的“拼接式”支架。研究用支架(长30 mm,直径10 mm)由三个带覆膜的金属片通过手术缝线连接组成。通过将缝线从网眼中拉出使支架收缩。狭窄形成两周后,通过内镜植入传统支架或新支架。四周后进行内镜取出。评估取出率、取出的难易程度、移位情况、并发症及存活率。
对照组15只动物中有3只(20%)发生支架移位,研究组15只动物中有2只(13%)发生支架移位;两组之间差异无统计学意义。四周结束时,研究组100%(11/11)的动物通过内镜成功取出剩余支架,对照组为60%(6/10)的动物;此差异有统计学意义(P < 0.05)。对照组和研究组的平均随访天数无差异(25.33对25.85)。研究组有5例报告有轻微出血,对照组有4例。两组均未出现与支架植入或取出直接相关的严重并发症。
在本良性食管狭窄的实验方案中,新型“拼接式”支架与传统支架相比,在移位率相似的情况下,取出率更高。