胃内に脱落した食道ステントを経内視鏡的に抜去し得た噴門癌の1例

概要

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We report an 78-year-old man reffered toour department for the management of dysphagia. Endoscopy revealed the cardiac gastric carcinoma and a 7cm-long invasion towards the esophagus. The covered self expanding metalic stent (WALLSTENTR, SCHINEIDER) was inserted. On the next day, the stent migrated 3cm down. The patient could swallow diet smoothly. 4 days later we started tegafur・uracil 600mg/day therapy and 3 weeks later, cisplatin 75mg drip infusion added. A month later, tumor overgrowth hap-pened to the proximal uncovered part. The second covered WALLSTENT was inserted at oral side and overlapped 7cm to the first stent. The secondstent was not migrated. 10 days later, the first stent was migrated down and collided to the stomach wall. We could not pull up the first stent by a baloon or forceps. 24 days later, both stents fell down to the stomach and connected with each other. We put in an overtube through the 2-chnnneled fiberscope, hanged the stent by a forceps, snared it, and put the stent into the overtube. The connection between the two stents aparted when the stent was removed with the overtube. A week later, the rest stent was removed by the same method. WALLSTENT can removeusing fiberscope. It is rare report that the removal of the WALLSTENT which was fallen into the stomach lumen using fiberscope.
Japan Gastroenterological Endoscopy Society Kanto Chapterの論文