Document Detail


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).
MedLine Citation:
PMID:  22196815     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Meike M Hirdes; Frank P Vleggaar; Hans-Ulrich Laasch; Peter D Siersema
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  75     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  174-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
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