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Erschienen in: Der Gastroenterologe 3/2014

01.05.2014 | Schwerpunkt

Stenting im Gastrointestinaltrakt

Probleme – Komplikationen – Lösungen

verfasst von: Prof. Dr. A. Dormann, R. Jakobs

Erschienen in: Die Gastroenterologie | Ausgabe 3/2014

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Zusammenfassung

Selbstexpandierende Metallstents sind etablierter Standard in der interventionellen Endoskopie des Gastrointestinaltrakts. Sie werden insbesondere zur Behandlung von malignen und benignen Stenosen, aber auch zum Verschluss von Leckagen und Anastomoseninsuffizienzen wie auch zur Blutstillung eingesetzt. Trotz vieler positiver Effekte und Vorteile im Vergleich zu operativen Alternativen haben die Metallstents auch Nachteile und können im Verlauf zu Problemen und ernsthaften Komplikationen führen. Die Hauptprobleme sind Stentdislokation oder -migration, Okklusion der Stents durch einwachsendes Gewebe, lokale Gewebeschädigungen bis zur Perforation und Blutung. Für viele dieser Situationen wurden je nach Einsatzgebiet des Stents endoskopische Lösungsmöglichkeiten entwickelt. Nur in wenigen Fällen sind für diese Komplikationen operative oder radiologisch-interventionelle Maßnahmen erforderlich.
Literatur
1.
Zurück zum Zitat Boeckel PG van, Dua KS, Weusten BL et al (2012) Fully covered self-expandable metal stents (SEMS), partially covered SEMS and self-expandable plastic stents for the treatment of benign esophageal ruptures and anastomotic leaks. BMC Gastroenterol 12: 19PubMedCentralPubMedCrossRef Boeckel PG van, Dua KS, Weusten BL et al (2012) Fully covered self-expandable metal stents (SEMS), partially covered SEMS and self-expandable plastic stents for the treatment of benign esophageal ruptures and anastomotic leaks. BMC Gastroenterol 12: 19PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Kahl S, Kähler G, Pross M, Tübergen G (2007) Rekanalisierungsverfahren am oberen und unteren Gastrointestinaltrakt. In: Kahl S, Kähler G, Dormann A (Hrsg) Interventionelle Endoskopie. Elsevier, München Kahl S, Kähler G, Pross M, Tübergen G (2007) Rekanalisierungsverfahren am oberen und unteren Gastrointestinaltrakt. In: Kahl S, Kähler G, Dormann A (Hrsg) Interventionelle Endoskopie. Elsevier, München
3.
Zurück zum Zitat Vleggaar FP, Siersema PD (2011) Expandable stents for malignant esophageal disease. Gastrointest Endosc Clin N Am 21: 377–388PubMedCrossRef Vleggaar FP, Siersema PD (2011) Expandable stents for malignant esophageal disease. Gastrointest Endosc Clin N Am 21: 377–388PubMedCrossRef
4.
Zurück zum Zitat Heel NC van, Haringsma J, Boot H et al (2012) Comparison of 2 expandable stents for malignant esophageal disease: a randomized controlled trial. Gastrointest Endosc 76: 52–58PubMedCrossRef Heel NC van, Haringsma J, Boot H et al (2012) Comparison of 2 expandable stents for malignant esophageal disease: a randomized controlled trial. Gastrointest Endosc 76: 52–58PubMedCrossRef
5.
Zurück zum Zitat Evrard S, Le Moine O, Lazaraki G et al (2004) Self-expanding plastic stents for benign esophageal lesions. Gastrointest Endosc 60: 894–900PubMedCrossRef Evrard S, Le Moine O, Lazaraki G et al (2004) Self-expanding plastic stents for benign esophageal lesions. Gastrointest Endosc 60: 894–900PubMedCrossRef
6.
Zurück zum Zitat Dormann AJ, Wigginghaus B, Deppe H, Huchzermeyer H (2001) Successful treatment of esophageal perforation with a removable self-expanding plastic stent. Am J Gastroenterol 96: 923–924PubMedCrossRef Dormann AJ, Wigginghaus B, Deppe H, Huchzermeyer H (2001) Successful treatment of esophageal perforation with a removable self-expanding plastic stent. Am J Gastroenterol 96: 923–924PubMedCrossRef
7.
Zurück zum Zitat Eickhoff A, Knoll M, Jakobs R et al (2005) Self-expanding metal stents versus plastic prostheses in the palliation of malignant dysphagia: long-term outcome of 153 consecutive patients. J Clin Gastroenterol 39: 877–885PubMedCrossRef Eickhoff A, Knoll M, Jakobs R et al (2005) Self-expanding metal stents versus plastic prostheses in the palliation of malignant dysphagia: long-term outcome of 153 consecutive patients. J Clin Gastroenterol 39: 877–885PubMedCrossRef
8.
Zurück zum Zitat Boeckel PG van, Vleggaar FP, Siersema PD (2013) Biodegradable stent placement in the esophagus. Expert Rev Med Devices 10: 37–43PubMedCrossRef Boeckel PG van, Vleggaar FP, Siersema PD (2013) Biodegradable stent placement in the esophagus. Expert Rev Med Devices 10: 37–43PubMedCrossRef
9.
Zurück zum Zitat Aymaz S, Dormann AJ (2008) A new approach to endoscopic treatment of tumors of the esophagogastric junction with individually designed self-expanding metal stents. World J Gastroenterol 14: 3919–3921PubMedCentralPubMedCrossRef Aymaz S, Dormann AJ (2008) A new approach to endoscopic treatment of tumors of the esophagogastric junction with individually designed self-expanding metal stents. World J Gastroenterol 14: 3919–3921PubMedCentralPubMedCrossRef
10.
Zurück zum Zitat Borgulya M, Ell C, Pohl J (2012) Transnasal endoscopy for direct visual control of esophageal stent placement without fluoroscopy. Endoscopy 44: 422–424PubMedCrossRef Borgulya M, Ell C, Pohl J (2012) Transnasal endoscopy for direct visual control of esophageal stent placement without fluoroscopy. Endoscopy 44: 422–424PubMedCrossRef
11.
Zurück zum Zitat Kochar R, Shah N (2013) Enteral stents: from esophagus to colon. Gastrointest Endosc 78: 913–918PubMedCrossRef Kochar R, Shah N (2013) Enteral stents: from esophagus to colon. Gastrointest Endosc 78: 913–918PubMedCrossRef
12.
Zurück zum Zitat Dormann A, Meisner S, Verin N, Wenk Lang A (2004) Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy 36: 543–550PubMedCrossRef Dormann A, Meisner S, Verin N, Wenk Lang A (2004) Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy 36: 543–550PubMedCrossRef
13.
Zurück zum Zitat Wigginghaus B, Dormann AJ, Grünewald T (2000) Self-expandable metallic stents in malignant gastric outlet obstructions – an alternative approach using modified techniques. Z Gastroenterol 38: 229–234PubMedCrossRef Wigginghaus B, Dormann AJ, Grünewald T (2000) Self-expandable metallic stents in malignant gastric outlet obstructions – an alternative approach using modified techniques. Z Gastroenterol 38: 229–234PubMedCrossRef
14.
Zurück zum Zitat Kim ID, Kang DH, Choi CW et al (2010) Prevention of covered enteral stent migration in patients with malignant gastric outlet obstruction: a pilot study of anchoring with endoscopic clips. Scand J Gastroenterol 45: 100–105PubMedCrossRef Kim ID, Kang DH, Choi CW et al (2010) Prevention of covered enteral stent migration in patients with malignant gastric outlet obstruction: a pilot study of anchoring with endoscopic clips. Scand J Gastroenterol 45: 100–105PubMedCrossRef
15.
Zurück zum Zitat Jakobs R (2013) Stentimplantation im Gallengang. Thieme, up2date 9: 2–4 Jakobs R (2013) Stentimplantation im Gallengang. Thieme, up2date 9: 2–4
16.
Zurück zum Zitat Dumonceau JM, Tringali A, Blero D et al (2012) Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 44: 277–298PubMedCrossRef Dumonceau JM, Tringali A, Blero D et al (2012) Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 44: 277–298PubMedCrossRef
17.
Zurück zum Zitat Moss AC, Morris E, Leyden J et al (2007) Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction. Eur J Gastroenterol Hepatol 19: 1119–1124PubMedCrossRef Moss AC, Morris E, Leyden J et al (2007) Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction. Eur J Gastroenterol Hepatol 19: 1119–1124PubMedCrossRef
18.
Zurück zum Zitat Coté GA, Kumar N, Ansstas M et al (2010) Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents. Gastrointest Endosc 72: 748–754PubMedCrossRef Coté GA, Kumar N, Ansstas M et al (2010) Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents. Gastrointest Endosc 72: 748–754PubMedCrossRef
19.
Zurück zum Zitat Kawakubo K, Isayama H, Nakai Y et al (2012) Risk factors for pancreatitis following transpapillary self-expandable metal stent placement. Surg Endosc 26: 771–776PubMedCrossRef Kawakubo K, Isayama H, Nakai Y et al (2012) Risk factors for pancreatitis following transpapillary self-expandable metal stent placement. Surg Endosc 26: 771–776PubMedCrossRef
20.
Zurück zum Zitat Tarantino I, Mangiavillano B, Di Mitri R et al (2012) Fully covered self-expandable metallic stents in benign biliary strictures: a multicenter study on efficacy and safety. Endoscopy 44: 923–927PubMedCrossRef Tarantino I, Mangiavillano B, Di Mitri R et al (2012) Fully covered self-expandable metallic stents in benign biliary strictures: a multicenter study on efficacy and safety. Endoscopy 44: 923–927PubMedCrossRef
21.
Zurück zum Zitat Moon SH, Kim MH, Park do H et al (2010) Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration. Gastrointest Endosc 72: 86–91PubMedCrossRef Moon SH, Kim MH, Park do H et al (2010) Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration. Gastrointest Endosc 72: 86–91PubMedCrossRef
22.
Zurück zum Zitat Park do H, Lee SS, Lee TH et al (2011) Anchoring flap versus flared end, fully covered self-expandable metal stents to prevent migration in patients with benign biliary strictures: a multicenter, prospective, comparative pilot study (with videos). Gastrointest Endosc 73: 64–70PubMedCrossRef Park do H, Lee SS, Lee TH et al (2011) Anchoring flap versus flared end, fully covered self-expandable metal stents to prevent migration in patients with benign biliary strictures: a multicenter, prospective, comparative pilot study (with videos). Gastrointest Endosc 73: 64–70PubMedCrossRef
23.
Zurück zum Zitat Tan DM, Lillemoe KD, Fogel EL (2012) A new technique for endoscopic removal of uncovered biliary self-expandable metal stents: stent-in-stent technique with a fully covered biliary stent. Gastrointest Endosc 75: 923–925PubMedCrossRef Tan DM, Lillemoe KD, Fogel EL (2012) A new technique for endoscopic removal of uncovered biliary self-expandable metal stents: stent-in-stent technique with a fully covered biliary stent. Gastrointest Endosc 75: 923–925PubMedCrossRef
24.
Zurück zum Zitat Ishii K, Itoi T, Sofuni A et al (2011) Endoscopic removal and trimming of distal self-expandable metallic biliary stents. World J Gastroenterol 17: 2652–2657PubMedCentralPubMedCrossRef Ishii K, Itoi T, Sofuni A et al (2011) Endoscopic removal and trimming of distal self-expandable metallic biliary stents. World J Gastroenterol 17: 2652–2657PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Cirocchi R, Farinella E, Trastulli S et al (2013) Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: a systematic review and meta-analysis. Surg Oncol 22: 14–21. doi: 10.1016/j.suronc.2012.10.003 (Epub 2012 Nov 24. Review)PubMedCrossRef Cirocchi R, Farinella E, Trastulli S et al (2013) Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: a systematic review and meta-analysis. Surg Oncol 22: 14–21. doi: 10.1016/j.suronc.2012.10.003 (Epub 2012 Nov 24. Review)PubMedCrossRef
26.
Zurück zum Zitat Sagar J (2011) Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev 11: CD007378. doi: 10.1002/14651858.CD007378.pub2 (Review)PubMed Sagar J (2011) Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev 11: CD007378. doi: 10.1002/14651858.CD007378.pub2 (Review)PubMed
Metadaten
Titel
Stenting im Gastrointestinaltrakt
Probleme – Komplikationen – Lösungen
verfasst von
Prof. Dr. A. Dormann
R. Jakobs
Publikationsdatum
01.05.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Gastroenterologie / Ausgabe 3/2014
Print ISSN: 2731-7420
Elektronische ISSN: 2731-7439
DOI
https://doi.org/10.1007/s11377-013-0856-1

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