Kochhar Rakesh, Samanta Jayanta, Basha Jahangeer, Verma Abhai, Choudhuri Gourdas, Lakhtakia Sundeep, Reddy D Nageshwar
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Dysphagia. 2017 Aug;32(4):575-582. doi: 10.1007/s00455-017-9800-8. Epub 2017 Apr 25.
Biodegradable (BD) stents have been used for the management of various esophageal strictures (ES) but the experience of its use in caustic strictures is limited. The present study, aimed at evaluating efficacy of BD stents for the treatment of refractory caustic-induced ES, was a retrospective multi-center study conducted at three tertiary care centers in India wherein adult patients with refractory caustic induced strictures underwent placement of a BD stent. Patients were followed up for immediate complications and long term outcome. All 13 patients (39.3 ± 15.1 years) underwent successful BD stent placement. Retrosternal chest pain occurred in 2 patients and stent migration in 1 (7.6%) patient. At 3 months, restenosis with recurrence of dysphagia was seen in nine (69.2%) patients, at 6 months, 10 (77%) patients had dysphagia of whom three underwent surgery and the remaining seven patients required dilatations. At 1 year, one patient remained asymptomatic while nine had dysphagia. The requirement for dilatation was once in 3 months in seven patients & once in a month in two patients. At 2 years, the requirement of dilatations was further reduced to once in 4-6 months in all patients. Over a 3 year follow up three (23%) patients had undergone surgery, one was free of symptoms while nine patients continued to be on periodic dilatation although the requirement had reduced to once in 4-6 months. Efficacy of BD stents in patients with caustic-induced ES is limited and the short term radial force applied by the currently available BD stents is inadequate to provide long term relief in such patients.
可生物降解（BD）支架已用于治疗各种食管狭窄（ES），但其在腐蚀性狭窄中的应用经验有限。本研究旨在评估BD支架治疗难治性腐蚀性食管狭窄的疗效，是在印度三个三级医疗中心进行的一项回顾性多中心研究，纳入了难治性腐蚀性食管狭窄的成年患者并为其植入BD支架。对患者进行随访，观察近期并发症和长期预后。所有13例患者（年龄39.3±15.1岁）均成功植入BD支架。2例患者出现胸骨后胸痛，1例患者（7.6%）发生支架移位。3个月时，9例患者（69.2%）出现再狭窄并伴有吞咽困难复发；6个月时，10例患者（77%）有吞咽困难，其中3例接受了手术，其余7例患者需要进行扩张治疗。1年时，1例患者无症状，9例有吞咽困难。7例患者每3个月需要扩张一次，2例患者每月需要扩张一次。2年时，所有患者扩张需求进一步减少至每4 - 6个月一次。在3年的随访中，3例患者（23%）接受了手术，1例无症状，9例患者尽管扩张需求已减少至每4 - 6个月一次，但仍需定期扩张。BD支架在腐蚀性食管狭窄患者中的疗效有限，目前可用的BD支架施加的短期径向力不足以为此类患者提供长期缓解。
