Usefulness of self-expandable metallic stent with an antireflux mechanism as a palliation for malignant strictures at the gastroesophageal junction |
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| Authors: | Osugi H Lee S Higashino M Tokuhara T Kaseno S Takada N Takemura M Mizumoto Y Kinoshita H |
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| Institution: | (1) Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-5-7 Asahi-machi, Abeno-ku, Osaka 545-8586, Japan, JP;(2) Department of Gastroenterological Surgery, Osaka City General Hospital, 22-13-2 Miyakojima-hondori, Miyakojima-ku, Osaka 534-0021, Japan, JP;(3) Department of Gastroenterology, National Kyoto Hospital, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan, JP |
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| Abstract: | BACKGROUND: Patients with unresectable malignant gastroesophageal strictures often are troubled with reflux esophagitis after
stent placement. METHODS: A self-expandable metallic stent (SEMS) without an antireflux mechanism was placed in seven patients
with unresectable malignant gastroesophageal strictures (group A), and SEMS with an antireflux mechanism was placed in five
patients (group B). After we obtained monitoring systems, two patients in group A and all the patients in group B underwent
measurement of bilirubin and pH in the esophagus using a 24-h bilirubin and pH monitor. RESULTS: The mean percentage of total
time less than 0.14 for use of the bilirubin absorbance unit was 12.4% in group B and 64.0% in group A. The mean percentage
of total time for a pH less than 4 was 2.9% in group B and 37.8% in group A. CONCLUSION: The placement of SEMS with the antireflux
mechanism can be effective not only for palliation of gastroesophageal stricture, but also for prevention of reflux. |
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