Usefulness of self-expandable metallic stent with an antireflux mechanism as a palliation for malignant strictures at the gastroesophageal junction.
BACKGROUND
Patients with unresectable malignant gastroesophageal strictures often are troubled with reflux esophagitis after stent placement.


METHODS
A self-expandable metallic stent (SEMS) without an antireflux mechanism was placed in seven patients with unresectable malignant gastroesophageal strictures (group A), and SEMS with an antireflux mechanism was placed in five patients (group B). After we obtained monitoring systems, two patients in group A and all the patients in group B underwent measurement of bilirubin and pH in the esophagus using a 24-h bilirubin and pH monitor.


RESULTS
The mean percentage of total time less than 0.14 for use of the bilirubin absorbance unit was 12.4% in group B and 64.0% in group A. The mean percentage of total time for a pH less than 4 was 2.9% in group B and 37.8% in group A.


CONCLUSIONS
The placement of SEMS with the antireflux mechanism can be effective not only for palliation of gastroesophageal stricture, but also for prevention of reflux.
Osugi
H
H
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-5-7 Asahi-machi, Abeno-ku, Osaka 545-8586, Japan. m9940141@msic.med.osaka-cu.ac.jp
Lee
S
S
Higashino
M
M
Tokuhara
T
T
Kaseno
S
S
Takada
N
N
Takemura
M
M
Mizumoto
Y
Y
Kinoshita
H
H
D000230:Adenocarcinoma / Q000150:complications / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy*; D002637:Chest Pain / Q000209:etiology; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D004940:Esophageal Stenosis / Q000628:therapy; D004943:Esophagogastric Junction / Q000503:physiopathology / Q000601:surgery*; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000628:therapy*; D005764:Gastroesophageal Reflux / Q000628:therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods; D010166:Palliative Care / Q000379:methods; D013193:Stainless Steel / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects
D013193:Stainless Steel; D001663:Bilirubin