title: Plastic tube-assisted gastroscopic removal of embedded esophageal metal stents: a case report.
abstract: A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy. The gastroscope was guided into the esophagus through the ST-E tube, and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope. Under gastroscopy, the stent wire was grasped with the forceps and pulled into the ST-E tube. When resistance was met during withdrawal, the gastroscope was guided further to the esophageal section where the stent was embedded. Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh. While the lower section of the Z-shaped stent was fixed by the biopsy forceps, the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated. The wire mesh of the stent was then removed in stages through the ST-E tube. Care was taken to avoid bleeding and perforation. Under the assistance of an ST-E plastic tube, an embedded esophageal metal stent was successfully removed with no bleeding or perforation. The patient experienced an uneventful recovery after surgery. Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive, safe, and effective.
authors.affiliation: Gui-Yong Peng, Xiu-Feng Kang, Xin Lu, Lei Chen, Qian Zhou, Department of Gastroenterology of Southwest Hospital, The Third Military Medical University, Chongqing 400038, China.
authors.forename: Gui-Yong
authors.initials: GY
authors.lastname: Peng
authors.forename: Xiu-Feng
authors.initials: XF
authors.lastname: Kang
authors.forename: Xin
authors.initials: X
authors.lastname: Lu
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D001983:Bronchial Fistula / Q000175:diagnosis / Q000628:therapy*; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods; D004937:Esophageal Fistula / Q000175:diagnosis / Q000628:therapy*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D020699:Gastroscopes; D005773:Gastroscopy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008670:Metals; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Complication; Esophagus; Gastroscope; Stents