Rösch T, Kyrein A, Zillinger C, Classen M
II. Medizinische Klinik und Poliklinik der Technischen Universität Klinikum rechts der Isar, München.
Chirurg. 1999 Aug;70(8):868-75. doi: 10.1007/s001040050736.
Self-expanding metal stents have, when introduced in their constrained form through gastrointestinal and biliary strictures, a relatively small diameter. Once placed through the stricture and released, however, they expand to a much larger internal diameter, thus giving rise to sufficient palliative reopening of these strictures. Since metal stents are usually not removable, their primary use has been in malignant stenoses. Benign strictures should be treated with metal stents only in exceptional situations. For palliation of dysphagia in esophagocardial malignancies, metal stents have been shown to be associated with significantly fewer initial complications on placement than plastic tubes. The long-term fate of both stent types seems to be similar. In the palliation of malignant jaundice, metal stents were demonstrated to have a significantly longer patency rate, resulting in a favourable cost-benefit ratio despite the high price of metal stents. Continued developments are necessary to further reduce long-term complications and effectiveness.
自膨式金属支架在以受限形式通过胃肠道和胆道狭窄置入时,直径相对较小。然而,一旦通过狭窄部位放置并释放,它们会扩张到更大的内径,从而使这些狭窄部位得到充分的姑息性再通。由于金属支架通常不可取出,其主要用于恶性狭窄。良性狭窄仅在特殊情况下才用金属支架治疗。对于食管心源性恶性肿瘤导致的吞咽困难的姑息治疗,已表明金属支架在置入时的初始并发症明显少于塑料导管。两种支架类型的长期转归似乎相似。在恶性黄疸的姑息治疗中,金属支架的通畅率明显更长,尽管金属支架价格高昂,但成本效益比良好。有必要持续改进以进一步降低长期并发症并提高有效性。