| Technical feasibility and safety of a new, implantable reflux control system to prevent gastroesophageal reflux in patients with stents placed through the lower esophageal sphincter (with video). | |
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MedLine Citation:
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PMID: 22196815 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: When an esophageal stent is placed through the lower esophageal sphincter (LES), gastroesophageal reflux symptoms may persist despite high-dose proton pump inhibitor therapy. A recently developed, short segment, uncovered nitinol stent with a tricuspid-like valve can be placed inside a previously placed esophageal stent. OBJECTIVE: To evaluate the technical feasibility and safety of a reflux control system (RCS) in distally placed esophageal stents. DESIGN: A prospective case series. SETTING: Two tertiary-care referral centers. PATIENTS: This study involved 10 patients who had an "open" stent placed through the LES and 1 patient with severe bile reflux after esophagojejunostomy. INTERVENTION: Placement of an RCS with fluoroscopic and (in selected cases) endoscopic guidance, from April to October 2010. MAIN OUTCOME MEASUREMENTS: Technical success of RCS placement and complications. RESULTS: Placement of an RCS was successful on the first attempt in all patients; complete expansion to the wall of the host stent was confirmed by fluoroscopy in all cases. In 3 patients, the host stent migrated in <1 month with the RCS still inside. In 8 patients, the RCS was in place for a median of 134 days (range 33-225 days). Three patients died because of malignant disease progression. Eight RCSs were removed endoscopically, together with the host stent without complications. RCS migration did not occur. LIMITATIONS: Small number of patients, nonrandomized design, lack of pH measurements. CONCLUSION: Placement of an RCS in a host stent is technically feasible and safe. An RCS can be considered in symptomatic patients with open esophageal stents to prevent gastroesophageal reflux. |
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Authors:
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Meike M Hirdes; Frank P Vleggaar; Hans-Ulrich Laasch; Peter D Siersema |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 75 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2011-12-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 174-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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