Published online Jul 28, 2018. doi: 10.3748/wjg.v24.i28.3192
Peer-review started: April 19, 2018
First decision: May 30, 2018
Revised: June 17, 2018
Accepted: June 27, 2018
Article in press: June 27, 2018
Published online: July 28, 2018
Stent migration, which causes issues in stent therapy for esophageal perforations, can counteract the therapeutic effects and lead to complications. Therefore, techniques to regulate stent migration are important and lead to effective stent therapy. Here, in these cases, we placed a removable fully covered self-expandable metallic stent (FSEMS) in a 52-year-old man with suture failure after surgery to treat Boerhaave syndrome, and in a 53-year-old man with a perforation in the lower esophagus due to acute esophageal necrosis. At the same time, we nasally inserted a Sengstaken-Blakemore tube (SBT), passing it through the stent lumen. By inflating a gastric balloon, the lower end of the stent was supported. When the stent migration was confirmed, the gastric balloon was lifted slightly toward the oral side to correct the stent migration. In this manner, the therapy was completed for these two patients. Using a FSEMS and SBT is a therapeutic method for correcting stent migration and regulating the complete migration of the stent into the stomach without the patient undergoing endoscopic rearrangement of the stent. It was effective for positioning a stent crossing the esophagogastric junction.
Core tip: Here, we report two cases of stent migrations that were managed using Sengstaken-Blakemore tubes, which prevented complete migration to the stomach. The correction of the stent position was easy, and did not require endoscopic guidance. By regulating the stents, nutrition management became possible through a nasoenteric feeding tube. Both patients were discharged after oral ingestion became possible.