SELF-EXPANDABLE METALLIC STENT WITH ANTI-REFLUX VALVE

Abstract

Background and Study Aims : The Song-type polyurethane-covered self-expandable metallic stent was first introduced in 1992 and widely used for palliative therapy of malignant strictures of the esophagus, however it is rarely employed for benign strictures. It is because it would cause ref lux esophagitis when the stent is placed in the lower esophagus. Patients and Methods : An 81-year-old male presented severe stricture of the lower esopha-gus due to reflux esophagitis with hiatal hernia. We employed the Song type polyurethane-covered self-expandable metallic stent with the anti-ref lux valve with the benign stricture. Anti -ref lux valve simply consisted of the polyurethane tube folded inwardly on the oral side of the stent. Results : The patient was relieved easily from dysphagia after the placement of the stent. No symptoms from reflux of the gastric juice occurred afterwards with the administration of a proton pump inhibitor. The stent was proved to be out of GI tract five months later. Conclusions : This case suggested that the stent with the anti-ref lux valve was safe and useful for the management of patients with benign strictures as well as malignant strictures who cannot tolerate surgical procedures.