Comparison of different intervention procedures in benign stricture of gastrointestinal tract

• Published in: World journal of gastroenterology : WJG Vol. 10; no. 3; pp. 410 - 414
• Main Authors: Cheng, Ying-Sheng, Li, Ming-Hua, Chen, Wei-Xiong, Chen, Ni-Wei, Zhuang, Qi-Xin, Shang, Ke-Zhong
• Format: Journal Article
• Language: English
• Published: United States Department of Radiology, Sixth People' s Hospital, Shanghai Jiaotong University, Shanghai 200233, China%Department of Gastroenterology,Sixth People' s Hospital, Shanghai Jiaotong University, Shanghai 200233, China 01.02.2004
• Subjects: Adolescent; Adult; Aged; Child; Dilatation; Female; Gastric Outlet Obstruction - therapy; Humans; Intestinal Obstruction - therapy; Male; Middle Aged; Stents; 介入疗法; 可膨胀金属支架; 膨胀气囊; 良性胃肠道狭窄; 远期疗效
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v10.i3.410

AIM:To determine the most effective intervention procedure by evaluation of mid and long-term therapeutic efficacy in patients of stricture of the gastrointestinal tract (GIT).METHODS:Different intervention procedures were used to treat benign stricture of GIT in 180 patients including pneumatic dilation (group A, n=80), permanent (group B,n=25) and temporary (group C, n=75) placement of expandable metallic stents.RESULTS:The diameters of the strictured GIT were significantly greater after the treatment of all procedures employed (P<0.01). For the 80 patients in group A, 160 dilations were performed (mean, 2.0 times per patient).Complications in group A included chest pain (n=20), reflux (n=16),and bleeding (n=6). Dysphagia relapse occurred in 24 (30%) and 48 (60%) patients respectively during 6-and-12 momth follow-up periods in group A. In group B, 25 uncovered or partially covered or antireflux covered expandable metallic stents were placed permantly,complications included chest pain (n=10), reflux (n=15),bleeding (n=3), and stent migration (n=4), and dysphagia relapse occurred in 5 (20%) and 3 patients (25%) during the 6-and-12 month follow-up periods, respectively. In group C,the partially covered expandable metallic stents were temporarily placed in 75 patients and removed after 3 to 7 days via gastroscope, complications including chest pain (n=30), reflux (n=9), and bleeding (n=12), and dysphagia relapse occurred in 9 (12%) and 8 patients (16%) during the 6-and-12 month follow-up periods, respectively. The placement and withdrawal of stents were all successfully performed. The follow-up of all patients lasted for 6 to 96 months (mean 45.3±18.6 months).CONCLUSION:The effective procedures for benign GIT stricture are pneumatic dilation and temporary placement of partially-covered expandable metallic stents. Temporary placement of partially-covered expandable metallic stents is one of the best methods for benign GIT strictures in mid and long-term therapeutic efficacy.