Chen J S, Luh S P, Lee F, Tsai C I, Lee J M, Lee Y C
Dept. of Surgery, National Taiwan University Hospital, Taipei.
Endoscopy. 2000 Jul;32(7):542-5. doi: 10.1055/s-2000-3813.
We report a case of a 75-year-old woman who received repeated metallic stent insertion for corrosive esophageal injury. She underwent esophagectomy and gastric tube reconstruction about 3 years after injury because both stents were occluded in turn by overgrowth of granulation tissue. The gross and microscopic changes of the esophagus secondary to prolonged stent insertion are described. In the literature, no reports of similar cases have been recorded. Our limited experience revealed that using metallic stents to treat benign esophageal stricture should be handled very cautiously because of the complications which can commonly occur and are difficult to manage. Repeated stent insertion, although effective for temporarily relieving dysphagia, is ineffective in the long run and can create complications. We suggest that the feasibility of esophagectomy should be evaluated after the improvement of the general condition of the patient.
我们报告一例75岁女性,其因腐蚀性食管损伤接受了多次金属支架置入术。损伤约3年后,由于两个支架先后被肉芽组织过度生长阻塞,她接受了食管切除术和胃管重建术。描述了长期置入支架后食管的大体和微观变化。在文献中,尚未记录到类似病例的报告。我们有限的经验表明,由于使用金属支架治疗良性食管狭窄常会出现且难以处理并发症,因此应非常谨慎地操作。重复置入支架虽然能有效暂时缓解吞咽困难,但从长远来看无效且会引发并发症。我们建议在患者一般状况改善后评估食管切除术的可行性。