Ramanaden D N, Crimmins R, Smith P M
Department of Gastroenterology, Llandough Hospital, Penarth, Cardiff, UK.
Eur J Gastroenterol Hepatol. 2000 Jul;12(7):751-3. doi: 10.1097/00042737-200012070-00006.
To determine how many oesophageal and oesophago-gastric malignancies could be successfully intubated endoscopically with an Atkinson tube, and how often a metal mesh tube would be required instead.
A consecutive series of 125 patients underwent endoscopy and intubation.
A total of 142 Atkinson tubes were inserted into 122 patients, and four metal mesh stents were put into three patients. The median hospital stay was 3 days, and 28 patients were treated as day cases.
Atkinson tube insertion failed in only one patient. There were eight oesophageal perforations (5.6%); the procedure-related mortality was 4%. Three patients required a metal mesh stent, as dilatation proved difficult because of prior radiotherapy in two and prior surgery in one.
Atkinson tubes are the stents of choice for inoperable oesophageal tumours because of low complication rates and cost efficiency. In 20% of patients, day case insertion was successful. Metal mesh stents should be reserved for those patients with tight post-radiotherapy or post-surgical strictures when dilatation is difficult.
确定使用阿特金森管进行内镜插管时，能成功插入多少例食管及食管胃恶性肿瘤患者，以及需要改用金属网管的频率。
对125例患者进行连续系列内镜检查及插管。
共对122例患者插入142根阿特金森管，对3例患者置入4个金属网管。中位住院时间为3天，28例患者按日间手术处理。
仅1例患者阿特金森管插入失败。有8例食管穿孔（5.6%）；与操作相关的死亡率为4%。3例患者需要金属网管，其中2例因先前接受放疗、1例因先前接受手术导致扩张困难。
由于并发症发生率低且成本效益高，阿特金森管是不可切除食管肿瘤的首选支架。20%的患者日间插入成功。金属网管应保留用于放疗后或手术后狭窄严重且扩张困难的患者。
