Bernik T R, Bernik S F, Morgenstern B R, Pindyck F, Wallack M K
Department of Surgery, Saint Vincents Hospital, 170 West 12th Street, New York, NY, USA.
Surg Endosc. 2000 Jun;14(6):594. doi: 10.1007/s004640000166. Epub 2000 Apr 28.
Patients with advanced or recurrent gastric cancer affecting the upper and lower gastrointestinal tract usually experience obstructive symptoms, causing a severe compromise in their quality of life. Surgery may not be feasible because of the patient's precarious medical condition and multilevel tumor infiltration. When faced with these circumstances, surgeons have few options. Parenteral nutrition and comfort measures are utilized when surgical bypass is not a tenable option. We herein describe a unique case of multilevel upper and lower gastrointestinal obstruction secondary to recurrent gastric cancer. The patient was treated palliatively through a combined surgical, radiological, and endoscopic approach by implanting a series of self-expanding metallic stents. To our knowledge, there are no previous reports of successful management of simultaneous strictures of the upper and lower gastrointestinal tract using this technique.
影响上下消化道的晚期或复发性胃癌患者通常会出现梗阻症状，严重影响其生活质量。由于患者病情不稳定且肿瘤多部位浸润，手术可能不可行。面对这种情况，外科医生的选择有限。当手术旁路不可行时，会采用肠外营养和舒适措施。我们在此描述一例复发性胃癌继发的多部位上下消化道梗阻的独特病例。通过植入一系列自膨式金属支架，采用手术、放射和内镜联合的方法对该患者进行了姑息治疗。据我们所知，此前尚无使用该技术成功治疗上下消化道同时狭窄的报道。
