Chandrasekar T S, Kalamegam Raja Yogesh, Janakan Gokul Bollu, Suriyanarayanan Sathiamoorthy, Menta Prasad Sanjeevaraya, Chandrasekar Viveksandeep Thoguluva
MedIndia Hospitals, 83, Valluvarkottam High Road, Nungambakkam, Chennai, 600 034, India.
Department of Gastroenterology and Hepatology, University of Kansas, Lawrence, KS, USA.
Indian J Gastroenterol. 2017 Sep;36(5):424-428. doi: 10.1007/s12664-017-0783-z. Epub 2017 Oct 5.
Self-expanding metal stenting is an established treatment modality in the management of esophageal growth and stricture. Reactive tissue ingrowth at the uncovered portion of the self-expanding metal stent (SEMS) anchors it in position, preventing its migration. When removal of such an embedded SEMS is clinically indicated, the procedure of endoscopic retrieval is fraught with serious complications. Temporary deployment of a larger fully covered "rescue" SEMS within the embedded SEMS has been reported to be useful in the extraction of the embedded SEMS. When the regression of embedding tissue, is only partially achieved by such "rescue" fully covered SEMS, further extraction of the embedded SEMS can prove to be technically challenging. Here we report two cases where a novel technique, namely the "double-step invagination technique," was useful in retrieving such embedded esophageal SEMS.
自膨式金属支架置入术是治疗食管肿物及狭窄的一种成熟的治疗方式。自膨式金属支架（SEMS）未覆盖部分的反应性组织长入将其固定在位，防止其移位。当临床上需要取出这种嵌入的SEMS时，内镜取出操作充满严重并发症。据报道，在嵌入的SEMS内临时置入一个更大的全覆膜“救援”SEMS有助于取出嵌入的SEMS。当这种“救援”全覆膜SEMS仅部分实现嵌入组织退缩时，进一步取出嵌入的SEMS在技术上可能具有挑战性。在此，我们报告两例应用一种新技术即“两步套入技术”成功取出此类嵌入食管的SEMS的病例。
