Follow - up study and evaluation of benign stricture of upper gastrointestinal tract with interventional procedure / 中华放射学杂志

ABSTRACT

Objective To make follow-up s tudy and e valuation of benign stricture of upper gastrointestinal tract (UGIT) with interv entional procedure. Methods There were 85 cases of benign stric ture of UGIT with interventional procedu re. There were 35 cases with pneumatic dilation (group A), 25 cases with permane nt (group B) placement, and 25 cases with temporary (group C) placement of expan dable metallic stent, respectively. All cases were completed under fluoroscopy. 35 cases of group A had 67 times dilations (mean 1.9 times). Fifteen partial co vered and 10 uncovered expandable metallic stents were permanently placed in the 25 ca ses of group B. 25 partial covered expandable metallic stents were temporari ly p laced in the 25 cases of group C, and the stents were drawn out via gastroscopy 3-7 days later. All stents placement and drawing were technically successful. T he most strictured diameters of UGIT were 0.7-8.5 mm before dilations and 5.1- 200 mm after dilations. Dysphagia scores of all cases were from grade 2 to 4 b efo re dilations, and from grade 0 to 1 after dilations. Follow-up time of all case s was from 6 months to 36 months (mean 19.1 months). Results Complications in group A included chest pain (n=10), reflux (n=8), and bleeding (n =3). Seven (20%) in 35 cases of group A had dysphagia relapse during follow-up over 6 months; 32 (91%) in 35 cases of group A had dysphagia relapse during follow-up over 12 mon t hs; 19(95%) in 20 cases of group A had dysphagia relapse during follow-up over 36 months. Complications in group B included chest pain (n=10), reflux (n =15), bleeding (n=3), and stent migration (n=4). Five (20%) in 25 case s of group B had dysp hagia relapse during follow-up over 6 months; 3(25%) in 12 cases of group B had dysphagia relapse during follow-up over 12 months; 3(60%) in 5 cases of gro up B had dysphagia relapse during follow-up over 36 months. Complications in group C included chest pain (n=10), reflux (n=3), and bleeding (n=4). 3( 12%) in 25 cases of group C had dysphagia relapse during follow-up over 6 months, 2(13.3%) in 1 5 cases of group C had dysphagia relapse during follow-up over 12 months; 1(12.5 % ) in 8 cases of group C had dysphagia relapse during follow-up over 36 months. ConclusionThe effective treatment method of benign stricture of UGIT with inte rventional procedure in short-term therapeutic efficiency were graded pneumatic dilation and temporary placement of partial covered expandable metallic stent. T emporary placement of partial covered expandable metallic stent was the first me thod of choice in the treatment of benign stricture of UGIT in terms of mid and long-term therapeutic efficiency.