Department of Critical Care Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-0023, Japan.
Department of Surgery, Iwate Medical University, School of Medicine, Morioka, Iwate 020-0023, Japan.
World J Gastroenterol. 2018 Jul 28;24(28):3192-3197. doi: 10.3748/wjg.v24.i28.3192.
Stent migration, which causes issues in stent therapy for esophageal perforations, can counteract the therapeutic effects and lead to complications. Therefore, techniques to regulate stent migration are important and lead to effective stent therapy. Here, in these cases, we placed a removable fully covered self-expandable metallic stent (FSEMS) in a 52-year-old man with suture failure after surgery to treat Boerhaave syndrome, and in a 53-year-old man with a perforation in the lower esophagus due to acute esophageal necrosis. At the same time, we nasally inserted a Sengstaken-Blakemore tube (SBT), passing it through the stent lumen. By inflating a gastric balloon, the lower end of the stent was supported. When the stent migration was confirmed, the gastric balloon was lifted slightly toward the oral side to correct the stent migration. In this manner, the therapy was completed for these two patients. Using a FSEMS and SBT is a therapeutic method for correcting stent migration and regulating the complete migration of the stent into the stomach without the patient undergoing endoscopic rearrangement of the stent. It was effective for positioning a stent crossing the esophagogastric junction.
支架迁移会影响食管穿孔的支架治疗效果，并导致并发症，因此，控制支架迁移的技术非常重要，可以实现有效的支架治疗。在这里，我们为一名 52 岁的 Boerhaave 综合征手术后缝线断裂的患者和一名 53 岁的因急性食管坏死导致下段食管穿孔的患者放置了可移除的全覆膜自膨式金属支架（FSEMS）。同时，我们经鼻腔插入 Sengstaken-Blakemore 管（SBT），使其穿过支架管腔。通过充气胃气球，支撑支架的下端。当确认支架迁移时，稍微将胃气球向口腔侧提起，以纠正支架迁移。通过这种方式，完成了这两名患者的治疗。使用 FSEMS 和 SBT 是一种治疗方法，可纠正支架迁移，并调节支架完全迁移到胃中，而无需患者进行内镜支架重新排列。它对于定位跨越食管胃连接部的支架非常有效。
