Korean Journal of Radiology

  • 제17권6호
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  • Pages.893-902
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  • 2016
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
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Efficacy of Retrievable Metallic Stent with Fixation String for Benign Stricture after Upper Gastrointestinal Surgery

  • Kim, Jeong-Eun (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Hyo-Cheol (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Myungsu (Department of Radiology, Seoul National University Hospital) ;
  • Hur, Saebeom (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Minuk (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Sang Hwan (Department of Radiology, Seoul National University Hospital) ;
  • Cho, Soo Buem (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Chan Sun (Department of Radiology, Seoul National University Hospital) ;
  • Han, Joon Koo (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2016.05.17
  • 심사 : 2016.07.31
  • 발행 : 2016.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To determine the efficacy of retrievable metallic stent with fixation string for benign anastomotic stricture after upper gastrointestinal (UGI) surgery. Materials and Methods: From June 2009 to May 2015, a total of 56 retrievable metallic stents with fixation string were placed under fluoroscopy guidance in 42 patients who were diagnosed with benign anastomotic stricture after UGI surgery. Clinical success was defined as achieving normal regular diet (NRD). Results: The clinical success rate after the first stent placement was 57.1% (24/42). After repeated stent placement and/or balloon dilation, the clinical success rate was increased to 83.3% (35/42). Six (14.3%) patients required surgical revision to achieve NRD. One (2.4%) patient failed to achieve NRD. Stent migration occurred in 60.7% (34/56) of patients. Successful rate of removing the stent using fixation string and angiocatheter was 94.6% (53/56). Distal migration occurred in 12 stents. Of the 12 stents, 10 (83.3%) were successfully removed whereas 2 could not be removed. No complication occurred regarding distal migration. Conclusion: Using retrievable metallic stent with a fixation string is a feasible option for managing early benign anastomotic stricture after UGI surgery. It can reduce complications caused by distal migration of the stent.

키워드

참고문헌

  1. Kim JH, Song HY, Park SW, Yoon CJ, Shin JH, Yook JH, et al. Early symptomatic strictures after gastric surgery: palliation with balloon dilation and stent placement. J Vasc Interv Radiol 2008;19:565-570 https://doi.org/10.1016/j.jvir.2007.11.015
  2. Palermo M, Acquafresca PA, Rogula T, Duza GE, Serra E. Late surgical complications after gastric by-pass: a literature review. Arq Bras Cir Dig 2015;28:139-143 https://doi.org/10.1590/S0102-67202015000200014
  3. Kim JH, Shin JH, Song HY. Fluoroscopically guided balloon dilation for benign anastomotic stricture in the upper gastrointestinal tract. Korean J Radiol 2008;9:364-370 https://doi.org/10.3348/kjr.2008.9.4.364
  4. Kim JH, Shin JH, Di ZH, Ko GY, Yoon HK, Sung KB, et al. Benign duodenal strictures: treatment by means of fluoroscopically guided balloon dilation. J Vasc Interv Radiol 2005;16:543-548 https://doi.org/10.1097/01.RVI.0000150033.13928.D4
  5. Song HY, Jung HY, Park SI, Kim SB, Lee DH, Kang SG, et al. Covered retrievable expandable nitinol stents in patients with benign esophageal strictures: initial experience. Radiology 2000;217:551-557 https://doi.org/10.1148/radiology.217.2.r00nv03551
  6. Yaffee DW, Solomon B, Xia Y, Grossi EA, Zervos MD, Bizekis CS. Initial outcomes of symmetrically flared covered nitinol stents for esophageal pathologies. Surg Laparosc Endosc Percutan Tech 2015;25:420-423 https://doi.org/10.1097/SLE.0000000000000127
  7. Ko HK, Song HY, Shin JH, Lee GH, Jung HY, Park SI. Fate of migrated esophageal and gastroduodenal stents: experience in 70 patients. J Vasc Interv Radiol 2007;18:725-732 https://doi.org/10.1016/j.jvir.2007.02.030
  8. Song HY, Lee DH, Seo TS, Kim SB, Jung HY, Kim JH, et al. Retrievable covered nitinol stents: experiences in 108 patients with malignant esophageal strictures. J Vasc Interv Radiol 2002;13:285-293 https://doi.org/10.1016/S1051-0443(07)61722-9
  9. Eloubeidi MA, Talreja JP, Lopes TL, Al-Awabdy BS, Shami VM, Kahaleh M. Success and complications associated with placement of fully covered removable self-expandable metal stents for benign esophageal diseases (with videos). Gastrointest Endosc 2011;73:673-681 https://doi.org/10.1016/j.gie.2010.11.014
  10. Kim HC, Han JK, Kim TK, Do KH, Kim HB, Park JH, et al. Duodenal perforation as a delayed complication of placement of an esophageal stent. J Vasc Interv Radiol 2000;11:902-904 https://doi.org/10.1016/S1051-0443(07)61809-0
  11. Henne TH, Schaeff B, Paolucci V. Small-bowel obstruction and perforation. A rare complication of an esophageal stent. Surg Endosc 1997;11:383-384 https://doi.org/10.1007/s004649900369
  12. Zhang W, Meng WJ, Zhou ZG. Multiple perforations of the jejunum caused by a migrated esophageal stent. Endoscopy 2011;43 Suppl 2 UCTN:E145-E146 https://doi.org/10.1055/s-0030-1256164
  13. Moxey PW, Khan AZ, Karanjia ND. A case of small-bowel perforation caused by a migrated duodenal stent. Endoscopy 2007;39 Suppl 1:E54 https://doi.org/10.1055/s-2006-944903
  14. Karatepe O, Acet E, Altiok M, Battal M, Adas G, Karahan S. Esophageal stent migration can lead to intestinal obstruction. N Am J Med Sci 2009;1:63-65
  15. Endo M, Kaminou T, Ohuchi Y, Sugiura K, Yata S, Adachi A, et al. Development of a new hanging-type esophageal stent for preventing migration: a preliminary study in an animal model of esophagotracheal fistula. Cardiovasc Intervent Radiol 2012;35:1188-1194 https://doi.org/10.1007/s00270-011-0240-9
  16. Lyons CD, Kim MP, Blackmon SH. A novel fixation procedure to eliminate covered self-expanding metal stent migration. Ann Thorac Surg 2012;94:1748-1750 https://doi.org/10.1016/j.athoracsur.2012.06.018
  17. Bae JS, Kim SH, Shin CI, Joo I, Yoon JH, Lee HJ, et al. Efficacy of gastric balloon dilatation and/or retrievable stent insertion for pyloric spasms after pyloruspreserving gastrectomy: retrospective analysis. PLoS One 2015;10:e0144470 https://doi.org/10.1371/journal.pone.0144470
  18. Bae JI, Shin JH, Song HY, Lee GH. Treatment of a benign anastomotic duodenojejunal stricture with a polytetrafluoroethylene-covered retrievable expandable nitinol stent. J Vasc Interv Radiol 2004;15:769-772 https://doi.org/10.1097/01.RVI.0000133551.41008.26
  19. Kim HC, Shin JH, Song HY, Park SI, Ko GY, Youn HK, et al. Fluoroscopically guided balloon dilation for benign anastomotic stricture after Ivor-Lewis esophagectomy: experience in 62 patients. J Vasc Interv Radiol 2005;16:1699-1704 https://doi.org/10.1097/01.RVI.0000185417.89885.2E
  20. Kim JH, Shin JH, Bae JI, Di ZH, Lim JO, Kim TH, et al. Gastric outlet obstruction caused by benign anastomotic stricture: treatment by fluoroscopically guided balloon dilation. J Vasc Interv Radiol 2005;16:699-704 https://doi.org/10.1097/01.RVI.0000153923.38343.72
  21. Zhang J, Ren L, Huo J, Zhu Z, Liu D. The use of retrievable fully covered self-expanding metal stent in refractory postoperative restenosis of benign esophageal stricture in children. J Pediatr Surg 2013;48:2235-2240 https://doi.org/10.1016/j.jpedsurg.2013.06.005
  22. Kim JH, Song HY, Choi EK, Kim KR, Shin JH, Lim JO. Temporary metallic stent placement in the treatment of refractory benign esophageal strictures: results and factors associated with outcome in 55 patients. Eur Radiol 2009;19:384-390 https://doi.org/10.1007/s00330-008-1151-2
  23. Chung KH, Lee SH, Park JM, Lee JM, Shin CM, Ahn SH, et al. Partially covered self-expandable metallic stent for postoperative benign strictures associated with laparoscopyassisted gastrectomy. Gastric Cancer 2016;19:280-286 https://doi.org/10.1007/s10120-014-0450-3
  24. Gangloff A, Lecleire S, Di Fiore A, Huet E, Iwanicki-Caron I, Antonietti M, et al. Fully versus partially covered selfexpandable metal stents in benign esophageal strictures. Dis Esophagus 2015;28:678-683 https://doi.org/10.1111/dote.12260
  25. Park JH, Song HY, Shin JH, Cho YC, Kim JH, Kim SH, et al. Migration of retrievable expandable metallic stents inserted for malignant esophageal strictures: incidence, management, and prognostic factors in 332 patients. AJR Am J Roentgenol 2015;204:1109-1114 https://doi.org/10.2214/AJR.14.13172
  26. Choi WJ, Park JJ, Park J, Lim EH, Joo MK, Yun JW, et al. Effects of the temporary placement of a self-expandable metallic stent in benign pyloric stenosis. Gut Liver 2013;7:417-422 https://doi.org/10.5009/gnl.2013.7.4.417
  27. Yoon CJ, Shin JH, Song HY, Lim JO, Yoon HK, Sung KB. Removal of retrievable esophageal and gastrointestinal stents: experience in 113 patients. AJR Am J Roentgenol 2004;183:1437-1444 https://doi.org/10.2214/ajr.183.5.1831437
  28. Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ. Complications of stent placement for benign stricture of gastrointestinal tract. World J Gastroenterol 2004;10:284-286 https://doi.org/10.3748/wjg.v10.i2.284
  29. Song HY, Park SI, Do YS, Yoon HK, Sung KB, Sohn KH, et al. Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 1997;203:131-136 https://doi.org/10.1148/radiology.203.1.9122381