Richardson Tom, Naidoo Gerlin, Rupasinghe Namal, Smart Howard, Bhattacharya Sayantan
Department of Digestive Diseases, Warrington Hospital, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK.
Endoscopy Unit, Royal Liverpool University Hospital, Liverpool, UK.
Clin Med Insights Gastroenterol. 2018 Dec 20;11:1179552218819492. doi: 10.1177/1179552218819492. eCollection 2018.
Peptic oesophageal stricture can be considered as the end result of prolonged gastro-oesophageal reflux. The 'gold standard' treatment for peptic stricture is endoscopic dilatation with balloon or bougie. It is predicted that up to 40% of patients remain symptomatic with dysphagia due to refractory (resistant to treatment) or recurrent strictures, needing frequent interventions at short intervals. Such patients have poor nutritional status due to the primary disease and are susceptible to complications related to repeated endoscopic dilatation such as bleeding and perforation. This general review aims to analyse existing published evidence and address the role of biodegradable stents in resistant peptic strictures as an alternative treatment to provide long-term dysphagia-free intervals.
消化性食管狭窄可被视为长期胃食管反流的最终结果。消化性狭窄的“金标准”治疗方法是使用球囊或探条进行内镜扩张。据预测,高达40%的患者会因难治性(对治疗有抵抗性)或复发性狭窄而持续出现吞咽困难症状,需要短期内频繁进行干预。这类患者由于原发性疾病而营养状况较差,并且易发生与反复内镜扩张相关的并发症,如出血和穿孔。这篇综述旨在分析已发表的现有证据,并探讨可生物降解支架在难治性消化性狭窄中作为一种替代治疗方法的作用,以提供长期无吞咽困难的间期。