Pikarsky A J, Efron J E, Weiss E G, Eisenberg P, Nogueras J J, Wexner S D
Department of Colorectal Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Fort Lauderdale, Fl 33309, USA.
Surg Endosc. 2000 Apr;14(4):372. doi: 10.1007/s004640010048. Epub 2000 Mar 9.
In recent years, the use of transanal stenting of malignant colonic strictures for the palliation of obstructive symptoms has increased. Due to the rectosigmoid angle, stenting sigmoid tumors is more troublesome than rectal lesions, but the difficulty may be overcome by using a two-team approach. The radiologist assists the endoscopist with the use of fluoroscopy to ensure proper positioning of both the colonoscope and the stent. The most common complication is stent migration, but stent obstruction and colonic perforation may also occur. We treated a woman suffering from metastatic gastric cancer with peritoneal metastases by creating a 12-cm stricture in the sigmoid colon. Two adjoining Wallstents were required to bridge the obstruction. Following migration of the proximal stent, a third stent was introduced to bridge the previous two stents with satisfactory outcome.
近年来，经肛门置入支架治疗恶性结肠狭窄以缓解梗阻症状的应用有所增加。由于直肠乙状结肠角的存在，置入支架治疗乙状结肠肿瘤比直肠病变更麻烦，但采用双团队方法可能克服这一困难。放射科医生在内镜检查过程中借助荧光透视协助，以确保结肠镜和支架均正确定位。最常见的并发症是支架移位，但也可能发生支架阻塞和结肠穿孔。我们治疗了一名患有转移性胃癌伴腹膜转移的女性，在其乙状结肠造成了一个12厘米的狭窄。需要两个相邻的Wallstent支架来跨越梗阻部位。近端支架移位后，又置入了第三个支架以连接前两个支架，结果令人满意。
