Lee S H
Department of Radiology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
Br J Radiol. 2001 Oct;74(886):891-900. doi: 10.1259/bjr.74.886.740891.
The role of oesophageal stenting continues to evolve, with several new stents currently on the market. These stents possess anti-reflux valves, internal plastic coatings and retrievable threads. In patients with malignant dysphagia, management should ideally take place within multi-disciplinary teams such that accurate tumour staging occurs prior to treatment. Multi-modality therapy can not only improve dysphagia and response rates but may also improve survival. Several non-surgical palliative techniques are available to recanalize malignant obstruction, including oesophageal stenting. Other therapeutic modalities include the use of endoluminal laser therapy, photodynamic therapy, argon beam and bipolar electrocoagulation, ethanol injection and intracavity brachytherapy. Their use often depends on local availability and expertise. Although the initial costs of metal stents are high, the overall costs compare favourably with other forms of palliative therapy that often require multiple procedures with repeated inpatient hospitalization. Treatment of refractory benign strictures with oesophageal stents remains uncommon and several recent reports using retrievable stents appear to improve outcome, although more work is required in this area.
食管支架的作用在不断演变，目前市场上有几种新型支架。这些支架具有抗反流瓣膜、内部塑料涂层和可回收丝线。对于恶性吞咽困难患者，理想的治疗应在多学科团队中进行，以便在治疗前进行准确的肿瘤分期。多模式治疗不仅可以改善吞咽困难和缓解率，还可能提高生存率。有几种非手术姑息技术可用于疏通恶性梗阻，包括食管支架置入术。其他治疗方式包括腔内激光治疗、光动力治疗、氩离子束和双极电凝、乙醇注射和腔内近距离放射治疗。它们的使用通常取决于当地的可获得性和专业知识。虽然金属支架的初始成本较高，但总体成本与其他形式的姑息治疗相比具有优势，其他形式的姑息治疗通常需要多次手术和反复住院。用食管支架治疗难治性良性狭窄仍然不常见，最近一些使用可回收支架的报告似乎改善了治疗效果，尽管在这一领域还需要更多的研究。
