Aoki T, Osaka Y, Takagi Y, Okada R, Shinohara M, Tsuchida A, Sato S, Koyanagi Y
Department of Surgery, Tokyo Medical University, Tokyo Japan.
Dis Esophagus. 2001;14(3-4):208-11. doi: 10.1046/j.1442-2050.2001.00186.x.
We evaluated the effect of two different therapies for 23 patients with inoperable esophageal cancer, of whom 13 patients underwent placement of a metallic stent and 10 received bypass surgery. We newly defined the improved level of food intake and the effective rate based on the grade of the patient's status in order to evaluate objectively. Although the effect of stent placement was significantly better than that of bypass surgery, there were no significant differences in the improved level of food intake and the effective rate between the two groups. Four out of 10 patients in the bypass group had suture insufficiency, resulting in no oral intake and a fatal outcome. In addition, the ratio of survival period of ability to ingest orally and in-hospital mortality was significantly favorable in the stent group compared with the bypass group. In conclusion, stent placement should be the first choice for inoperable malignant stenosis or esophageal fistula.
我们评估了两种不同疗法对23例无法手术的食管癌患者的疗效，其中13例患者接受了金属支架置入术，10例接受了旁路手术。为了进行客观评估，我们根据患者的状态等级重新定义了食物摄入改善水平和有效率。尽管支架置入术的效果明显优于旁路手术，但两组在食物摄入改善水平和有效率方面没有显著差异。旁路手术组的10例患者中有4例出现缝合口漏，导致无法经口进食并最终死亡。此外，与旁路手术组相比，支架置入术组的经口进食生存期比例和住院死亡率明显更有利。总之，对于无法手术的恶性狭窄或食管瘘，支架置入术应作为首选治疗方法。
