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首页> 外文期刊>Gastrointestinal Endoscopy >Endoscopic removal of self-expandable metal stents from the esophagus (with video).
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Endoscopic removal of self-expandable metal stents from the esophagus (with video).

机译：内窥镜从食道中取出可自我扩张的金属支架（带视频）。

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BACKGROUND: Self-expandable metals stents (SEMSs) have increasingly been used as a temporary device to bridge chemoradiotherapy in patients with malignant esophageal disease or in patients with benign esophageal defects or stenosis. OBJECTIVE: To evaluate the outcome of removal of SEMSs in a large cohort of patients with benign and malignant esophageal disease. DESIGN: Observational study with standardized treatment and follow-up. SETTING: Single university center. PATIENTS: Between 2001 and 2010, 95 consecutive patients referred for endoscopic SEMS extraction were included. INTERVENTIONS: Endoscopic stent removal. MAIN OUTCOME MEASUREMENTS: Technical and functional outcome and complications. RESULTS: A total of 124 stent extractions were undertaken in 95 patients; both partially covered (68%) and fully covered (32%) SEMSs were removed. Three patients had 2 overlapping SEMSs in place. Successful primary removal was achieved in 89%; the secondary removal rate was 96%. Uncomplicated primary removal rate was significantly higher for fully covered versus partially covered stents (P = .035) and for single versus overlapping stents (P = .033). Patients with a complicated stent removal had the stent in place significantly longer compared with patients with an uncomplicated primary stent removal (126 days vs 28 days; P = .01). Surgical removal was required in 3 patients (2.4%). Six moderate and severe complications (5%) related to the endoscopic extraction occurred. LIMITATIONS: Retrospective, nonrandomized study design. CONCLUSIONS: Primary endoscopic removal of an SEMS is feasible in the majority of patients with benign and malignant esophageal disease. A longer time that a stent is in place and the use of partially covered SEMSs both impede removal. Moreover, overlapping SEMSs should be avoided for temporary use because stent disintegration and subsequent complications may occur.
机译：背景：自膨胀金属支架（SEMSs）已越来越多地用作在恶性食管疾病患者或良性食管缺陷或狭窄患者中进行放化疗的临时设备。目的：评估在一大批良性和恶性食管疾病患者中去除SEMS的结果。设计：采用标准化治疗和随访的观察性研究。地点：单一大学中心。患者：2001年至2010年，纳入了95例接受内镜SEMS提取的连续患者。干预措施：内窥镜支架切除术。主要指标：技术和功能指标及并发症。结果：95例患者共进行了124次支架置入术。删除了部分覆盖（68％）和完全覆盖（32％）的SEMS。 3例患者有2处重叠的SEMS。成功的初次清除率达到89％;二次去除率为96％。对于完全覆盖的支架与部分覆盖的支架（P = .035）以及对于单个支架与重叠支架（P = .033），简单的初次切除率明显更高。与不进行简单的一次支架切除术的患者相比，进行了复杂的支架切除术的患者的支架放置时间明显更长（126天vs 28天; P = 0.01）。 3例（2.4％）需要手术切除。发生了六例与内窥镜摘除有关的中度和重度并发症（5％）。局限性：回顾性，非随机研究设计。结论：对于大多数患有良性和恶性食管疾病的患者，内镜下手术切除SEMS是可行的。放置支架的时间较长，并且使用部分覆盖的SEMS都会阻碍移除。此外，应避免重叠的SEMS暂时使用，因为可能会发生支架分解和随后的并发症。

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