Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, 450052, China.
Abdom Radiol (NY). 2024 May;49(5):1646-1652. doi: 10.1007/s00261-024-04281-0. Epub 2024 Apr 9.
To evaluate the efficacy and safety of a novel technique for removal of migrated esophageal stent (MES) under fluoroscopy.
From January 2009 to April 2023, 793 patients with a dysphagia score of 3-4 underwent esophageal stenting at our center, and 25 patients (mean age: 70.06 years old; male/female: 15/10) underwent stent removal using "loop method" under fluoroscopy. The primary outcomes were technical success and complications. The secondary outcomes were procedure time, radiation exposure, biochemical indicators [white blood cell (WBC), hemoglobin (Hb), platelet (PLT), albumin (ALB), alanine transaminase (ALT), total bilirubin (TB), urea nitrogen (UN) and C-reactive protein] of pre- and post-treatment at 2 weeks.
Technical success was 100% without major complications. The mean procedure time was (39.44 ± 9.28) minutes, which showed no statistical significance between benign (n = 5) and malignant (n = 20) group [(42.40 ± 8.85) vs (38.71 ± 9.46) mins, p > 0.05]. The mean radiation exposure was (332.88 ± 261.47) mGy, which showed no statistical significance between benign and malignant group [(360.74 ± 231.43) vs (325.92 ± 273.54) mGy, p > 0.05]. Pre- and post-procedure Hb [(114.46 ± 11.96) vs. (117.57 ± 13.12) g/L] and ALB [(42.26 ± 3.39) vs. (44.12 ± 3.77) g/L] showed significant difference (p < 0.05), while WBC, PLT, CRP, and ALT showed no significance (p > 0.05).
Fluoroscopy-guided "Loop method" for MES removal is an effective and safe alternative technique.
评估一种在透视下移除迁移性食管支架(MES)的新方法的疗效和安全性。
从 2009 年 1 月至 2023 年 4 月,我院对 793 例吞咽困难评分 3-4 分的患者进行了食管支架置入术,其中 25 例患者(平均年龄:70.06 岁;男/女:15/10)采用透视下“套圈法”进行支架取出。主要结局为技术成功率和并发症。次要结局为手术时间、辐射暴露、治疗前后 2 周的生化指标[白细胞(WBC)、血红蛋白(Hb)、血小板(PLT)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、总胆红素(TB)、尿素氮(UN)和 C 反应蛋白]。
技术成功率为 100%,无严重并发症。平均手术时间为(39.44±9.28)min,良性(n=5)和恶性(n=20)组之间无统计学差异[(42.40±8.85)vs.(38.71±9.46)min,p>0.05]。平均辐射暴露量为(332.88±261.47)mGy,良性和恶性组之间无统计学差异[(360.74±231.43)vs.(325.92±273.54)mGy,p>0.05]。治疗前后 Hb[(114.46±11.96)vs.(117.57±13.12)g/L]和 ALB[(42.26±3.39)vs.(44.12±3.77)g/L]差异有统计学意义(p<0.05),而 WBC、PLT、CRP 和 ALT 差异无统计学意义(p>0.05)。
透视引导下的“套圈法”是一种有效且安全的移除 MES 的替代技术。