Kubota Yo, Nishiyama Ryu, Sasaki Masaya, Sakabe Yuta, Doi Kusutaro, Kitagawa Hiroyuki, Kikuchi Hidehiko, Kusano Chika
Department of Gastroenterology Hiratsuka Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Kanagawa Japan.
Department of Gastroenterology Kitasato University School of Medicine Kanagawa Japan.
DEN Open. 2024 Mar 2;4(1):e342. doi: 10.1002/deo2.342. eCollection 2024 Apr.
Although esophageal stenting is one treatment option as a palliative treatment for tracheoesophageal fistulas, serious complications are associated with stent migration. Some reports have described stent fixation using various devices to prevent stent migration. However, these have yet to be sufficiently examined. We performed esophageal stent fixation using the MANTIS Clip (Boston Scientific), a novel re-openable endoclip. An 89-year-old man developed a tracheoesophageal fistula after radiotherapy for esophageal squamous cell carcinoma. Esophageal stenting was considered because the patient had difficulty with oral intake. However, the patient had a mild stenosis, which suggested stent migration. Therefore, we performed esophageal stent fixation by grasping the mouth side of the stent and the normal mucosa of the esophagus with the MANTIS Clip after placement of the stent. The esophageal stent closed the fistula, and the patient was able to take food orally. Upper gastrointestinal endoscopy performed 3 weeks after stenting showed residual MANTIS Clip and no evidence of stent migration. Esophageal stent fixation with MANTIS clips for tracheoesophageal fistulas may be an option to prevent stent migration.
尽管食管支架置入术是治疗气管食管瘘的一种姑息治疗选择，但严重并发症与支架移位有关。一些报告描述了使用各种装置进行支架固定以防止支架移位。然而，这些方法尚未得到充分研究。我们使用一种新型可重新打开的内镜夹——MANTIS Clip（波士顿科学公司）进行食管支架固定。一名89岁男性在接受食管鳞状细胞癌放疗后发生气管食管瘘。由于患者经口进食困难，考虑进行食管支架置入术。然而，患者存在轻度狭窄，提示可能发生支架移位。因此，在放置支架后，我们用MANTIS Clip夹住支架的口侧和食管正常黏膜进行食管支架固定。食管支架封闭了瘘口，患者能够经口进食。支架置入3周后进行的上消化道内镜检查显示MANTIS Clip残留，且无支架移位迹象。使用MANTIS夹进行食管支架固定治疗气管食管瘘可能是预防支架移位的一种选择。
