Clinical Research
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 1, 2004; 10(3): 410-414
Published online Feb 1, 2004. doi: 10.3748/wjg.v10.i3.410
Comparative observation on different intervention procedures in benign stricture of gastrointestinal tract
Ying-Sheng Cheng, Ming-Hua Li, Wei-Xiong Chen, Ni-Wei Chen, Qi-Xin Zhuang, Ke-Zhong Shang
Ying-Sheng Cheng, Ming-Hua Li, Qi-Xin Zhuang, Ke-Zhong Shang, Department of Radiology, Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China
Wei-Xiong Chen, Ni-Wei Chen, Department of Gastroenterology, Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China
Author contributions: All authors contributed equally to the work.
Supported by the National Key Medical Research and Development Program of China during the 9th Five-year Plan Period, No.96-907-03-04; Shanghai Nature Science Funds, No.02Z1314073; Shanghai Medical Development Funds, No.00419
Correspondence to: Dr. Ying-Sheng Cheng, Department of Radiology, Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China. chengys@sh163.net
Telephone: +86-21-64368920 Fax: +86-21-64701361
Received: May 15, 2003
Revised: May 25, 2003
Accepted: June 2, 2003
Published online: February 1, 2004
Abstract

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.

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