Repici A, Reggio D, De Angelis C, Barletti C, Marchesa P, Musso A, Carucci P, Debernardi W, Falco M, Rizzetto M, Saracco G
Department of Gastroenterology, Molinette Hospital, Torino, Italy.
Gastrointest Endosc. 2000 Dec;52(6):735-40. doi: 10.1067/mge.2000.109803.
Metal stents have been reported as an effective alternative to surgery for the palliation of patients with colorectal neoplastic obstruction. Because most of the published series describe the use of uncovered stents, the purpose of our study was to prospectively evaluate the effectiveness, feasibility, safety, and outcome of covered stents for the palliative treatment of malignant colorectal strictures.
Sixteen patients with advanced distal colorectal cancer underwent placement of 10 and 12 cm long, 23 mm diameter covered stents under fluoroscopic and endoscopic control. Clinical and endoscopic follow-up was scheduled at 3- to 6-week intervals.
Stent insertion was successful in 15 of 16 patients (93%). Perforation occurred in one patient during stent placement requiring colostomy. Relief of bowel obstruction was documented in all successfully treated patients. The median follow-up was 21 weeks (range 1 to 46). No recurrence of obstruction was observed during the follow-up period. Stent migration occurred in 2 patients, 7 and 21 days after stent placement.
Covered stents may provide safe and effective palliation of patients with malignant rectosigmoid strictures. Prolonged luminal patency and sealing of fistulous tracts are potential advantages of covered versus uncovered stents in the palliative treatment of colorectal malignancies. ¿
据报道，金属支架可作为手术的有效替代方法，用于缓解结直肠肿瘤梗阻患者的症状。由于大多数已发表的系列研究描述的是裸支架的使用，我们研究的目的是前瞻性评估覆膜支架姑息治疗恶性结直肠狭窄的有效性、可行性、安全性及预后。
16例晚期低位结直肠癌患者在透视和内镜引导下置入10 cm和12 cm长、直径23 mm的覆膜支架。临床和内镜随访计划每3至6周进行一次。
16例患者中有15例（93%）成功置入支架。1例患者在支架置入过程中发生穿孔，需要行结肠造口术。所有成功治疗的患者均记录到肠梗阻缓解。中位随访时间为21周（范围1至46周）。随访期间未观察到梗阻复发。2例患者分别在支架置入后7天和21天发生支架移位。
覆膜支架可为恶性直肠乙状结肠狭窄患者提供安全有效的姑息治疗。在结直肠恶性肿瘤的姑息治疗中，与裸支架相比，覆膜支架具有延长管腔通畅时间和封闭瘘管的潜在优势。
