评估在良性上消化道疾病中固定全覆盖自膨胀金属支架的无固定、内窥镜缝合固定和镜外夹：一项多中心国际比较研究（附视频）。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy Pub Date : 2025-03-01 DOI:10.1016/j.gie.2024.08.015

Amit Mehta MD , Ashraf Ashhab MD , Apurva Shrigiriwar MD , Redeat Assefa MD , Andrew Canakis DO , Michael Frohlinger MD , Christopher A. Bouvette MD , Gregus Matus MD , Paul Punkenhofer MD , Francesco Vito Mandarino MD , Francesco Azzolini MD , Jamil S. Samaan MD , Rashmi Advani MD , Shivani K. Desai MD , Bradley Confer DO , Vikas K. Sangwan MD , Jonh J. Pineda-Bonilla MD , David P. Lee MD , Kinnari Modi MD , Chiemeziem Eke MD , Mouen A. Khashab MD

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引用次数: 0

摘要

背景和目的：全覆盖自膨胀金属支架（FCSEMS）广泛应用于良性上消化道疾病，但支架移位仍是一个限制因素。最近开发了一种用于支架固定的镜外夹（OTSC）装置（Ovesco Endoscopy）。本研究旨在评估 OTSC 固定对 SEMS 移位率的影响：方法：对 2011 年 1 月 1 日至 2022 年 10 月 10 日期间在 16 个中心因良性上消化道疾病接受 FCSEMS 置入术的连续患者进行回顾性研究。主要结果是支架移位率。次要结果为临床成功率和不良事件：共有 311 例（无固定 122 例、OTSC 94 例、内镜缝合 95 例）患者接受了 316 例支架植入手术。与无固定（NF）组（n=49，39%）相比，OTSC（SF）组（n=16，17%，p=0.001）和内镜缝合（ES）组（n=23，24%，p=0.01）的支架移位率显著降低。SF 组和 ES 组的支架移位率没有差异（P=0.2）。多变量分析显示，SF 组（OR 0.34，CI 0.17-0.70，P=0.01）和 ES 组（N=23，24，P=0.01）的支架移位率没有差异（P=0.2）：使用 OTSC 进行支架固定既安全又能有效防止支架移位，还能改善临床反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Evaluating no fixation, endoscopic suture fixation, and an over-the-scope clip for anchoring fully covered self-expandable metal stents in benign upper GI conditions: a comparative multicenter international study (with video)

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Background and Aims

Fully covered self-expandable metal stents (FCSEMSs) are widely used in benign upper GI conditions, but stent migration remains a limitation. An over-the-scope clip (OTSC) device (Stentfix {SF], Ovesco Endoscopy) for stent anchoring has recently been developed. The aim of this study was to evaluate the effect of OTSC fixation on FCSEMS migration rate.

Methods

In this retrospective review of consecutive patients who underwent FCSEMS placement for benign upper GI conditions from January 2011 to October 2022 at 16 centers, the primary outcome was rate of stent migration. The secondary outcomes were clinical success and adverse events.

Results

A total of 311 (no fixation [NF] 122, SF 94, endoscopic suturing [ES] 95) patients underwent 316 stenting procedures. Compared with the NF group (n = 49, 39%), the rates of stent migration were significantly lower in the SF (n = 16, 17%, P = .001) and ES (n = 23, 24%, P = .01) groups. The rates of stent migration were not different between the SF and ES groups (P = .2). On multivariate analysis, SF (odds ratio [OR], 0.34, 95% CI, 0.17-0.70, P < .01) and ES (OR, 0.46, 95% CI, 0.23-0.91; P = .02) were independently associated with decreased risk of stent migration. Compared with the NF group (n = 64; 52%), there were higher rates of clinical success in the SF (n = 64; 68%; P = .03) and ES (n = 66; 69%; P = .02) groups. There was no significant difference in the rates of adverse events among the 3 groups.

Conclusion

Stent fixation using OTSCs is safe and effective at preventing stent migration and may also result in improved clinical response.

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.