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Double layered self-expanding metal stents for malignant esophageal obstruction, especially across the gastroesophageal junction

查看全文 作　　者：Min Dae [1]Kim;Su Bum [2]Park;Dae Hwan [2]Kang;Jae Hyung [1]Lee;Cheol Woong [2]Choi;Hyung Wook [2]Kim;Chung Uk [2]Chung;Young Il [2]Jeong 高影响力作者 机构地区：[1]Department of Internal Medicine, Bongseng Memorial Hospital, Busan 601-723, South Korea;[2]Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 626-770, South Korea高影响力机构 出　　处：《World Journal of Gastroenterology》索引2012年第18卷第28期,共6页高影响力期刊 基　　金：Supported by A grant from the Korea Healthcare Technology R and D Project, Ministry for Health, Welfare and Family Affairs, South Korea, No. A091047 摘　　要：AIM: To evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ). METHODS: Forty eight patients who underwent the SEMS insertion for malignant esophageal obstruction were enrolled. Patients were classified as GEJ group (SEMS across GEJ, 18 patients) and non-GEJ group (SEMS above GEJ, 30 patients) according to SEMS position. Double layered (outer uncovered and inner covered stent) esophageal stents were placed. RESULTS: The SEMS insertion and the clinical improvement were achieved in all patients in both groups. Stent malfunction occurred in seven patients in the GEJ group and nine patients in the non-GEJ group. Tumor overgrowth occurred in five and eight patients, respectively, food impaction occurred in one patient in each group, and stent migration occurred in one and no patient, respectively. There were no significant differences between the two groups. Reflux esophagitis occurred more frequently in the GEJ group (eight vs five patients, P = 0.036) and was controlled by proton pump inhibitor. Aspiration pneumonia occurred in zero and five patients, respectively, and tracheoesophageal fistula occurred in zero and two patients, respectively. CONCLUSION: Double-layered SEMS are a feasible and effective treatment when placed across the GEJ for malignant esophageal obstruction. Double-layered SEMS provide acceptable complications, especially migration, although reflux esophagitis is more common in the GEJ group. 关 键 词：金属支架 交界处 食管 梗阻 恶性 治疗 SEMS 质子泵抑制剂
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