[ Objective ] To analyze the efficacy and safety of the endoscopic treatment of benign esophageal perforation using covered metal stents. [Methods] All the literatures in Chinese and in English about benign esophageal perforation which was treated by covered metal stents implantation under endoscope were retrievaled and summarized. [ Results ] In all 693 cases of benign esophageal perforation, the most common causes were anastomotic leakage, spontaneous and iatrogenic. Six hundred and nine cases were completely healed by using covered metal stents (87.88%), eighty-four cases failed, while seventy-four cases were healed by other means, such as clips and operations, nine cases died and one abandoned treatment. Compared with 38 cases of acute esophageal perforation, healing rate of 280 cases with chronic perforation was not significantly different (P >0.05), while stents related complications in chronic group (59 cases, 21.07%) was more than that of acute group (4 cases, 10.53%), and more cases needed multiple endoscopic treatments in chronic group than that of acute group (52 cases, 18.57% vs. 1 cases, 2.63%, P <0.05). The stents were retrieved endoscopically after a median of 28 days in acute group (range, 10 to 150 days), while 46 days (range, 14 to 294 days) in chronic group. [Conclusion] Treatment of benign esophageal perforation with covered metal stents endoscopically is effective, safe. To prevent complications, the stents should be removed when perforation is totally sealed.%目的 分析国内外内镜下放置金属覆膜支架治疗良性食管穿孔的疗效及安全性,为临床治疗提供依据.方法 通过检索国内外所有内镜下放置金属覆膜支架治疗良性食管穿孔的中、英文文献并进行统计分析.结果 总计有693例良性食管穿孔患者采用内镜下放置金属覆膜支架治疗,最常见的原因为吻合口瘘和自发性、医源性,其中609例采用金属覆膜支架治疗完全愈合(87.88％),84例失败,但74例通过其他方法如钛夹、手术等治疗后愈合,死亡9例,1例放弃治疗.与38例急性穿孔组相比,280例慢性穿孔组的完全愈合率差异无显著性,但因纵隔和胸膜感染多见,需进行引流、冲洗、清创等辅助治疗的比例显著升高(78.21％ vs 5.26％,P＜0.001),且需多次支架治疗者亦增多,并发症相对增高；支架取出时间也延长.结论 内镜下放置金属覆膜支架治疗良性食管穿孔疗效确切,安全性高,一旦瘘口愈合,应尽早取出支架,以减少并发症.
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