Ackroyd R, Watson D I, Devitt P G, Jamieson G G
University of Adelaide, Department of Surgery, Royal Adelaide Hospital, South Australia, Australia.
J Gastroenterol Hepatol. 2001 Apr;16(4):484-7. doi: 10.1046/j.1440-1746.2001.02367.x.
Expandable metallic stents have become popular in recent years for the treatment of esophageal strictures. While they are undoubtedly of great value in the palliation of malignant strictures and tracheo-esophageal fistulas, there is concern over their use for the treatment of benign diseases. We report three cases, in which such problems were seen following stent insertion for benign esophageal strictures. All three patients developed further strictures above the stents, one was complicated by a tracheo-esophageal fistula and two stents (in one patient) migrated distally into the stomach. Two of the patients underwent subsequent esophageal surgery. In both cases, this proved extremely difficult and hazardous because of the intense fibrotic reaction induced by the stents. Expandable mesh stents should not be used for the treatment of benign esophageal strictures without careful consideration of the potential problems, which can include rendering the problem inoperable.
近年来，可扩张金属支架在治疗食管狭窄方面已变得很普遍。虽然它们在缓解恶性狭窄和气管食管瘘方面无疑具有巨大价值，但对于其用于治疗良性疾病仍存在担忧。我们报告三例病例，在这些病例中，为良性食管狭窄置入支架后出现了此类问题。所有三名患者在支架上方均出现了进一步的狭窄，一名患者并发气管食管瘘，两名患者（其中一名患者）的两个支架向远端移入胃内。两名患者随后接受了食管手术。在这两例病例中，由于支架引发的强烈纤维化反应，手术证明极其困难且危险。在未仔细考虑潜在问题（包括可能使问题无法手术治疗）的情况下，不应将可扩张网状支架用于治疗良性食管狭窄。
