Smedh Kennet, Birgisson Helgi, Raab Yngve, Strand Eva, Karlsson Catharina
Kolorektalsektionen, kirurgkliniken, Centrallasarettet, Västerås.
Lakartidningen. 2003 May 28;100(22):1982-6.
Emergency operations for obstructing colorectal cancer are associated with high morbidity and mortality rates and often result in a temporary or permanent colostomy. A colorectal stent can be used both for palliation and as a "bridge to surgery". Twenty-three patients with obstructive sigmoid or rectal cancer were selected for stenting. Self-expanding metal mesh stents were placed under endoscopic and flouroscopic guidance. Stent placement was technically successful in 19 patients and clinical success was seen in 18. There were only three minor complications, no major and no procedure related mortality. Four patients were later resected without a diverting stoma, two with rectal cancer had preoperative MRI and radiotherapy. In 15 patients the procedure was regarded as palliative. Stent migration was noted in four patients but symptomatic reobstruction did not occur, no patient needed later surgery. Colorectal stenting procedure is effective and safe and can be used in obstructing cancers both as a temporary relief before elective resection and as a definitive treatment in palliative cases.
结直肠癌梗阻的急诊手术与高发病率和死亡率相关，且常导致临时或永久性结肠造口术。结肠直肠支架可用于缓解症状以及作为“手术桥梁”。选择23例乙状结肠或直肠癌梗阻患者进行支架置入。自膨式金属网状支架在内镜和荧光镜引导下置入。19例患者支架置入技术成功，18例获得临床成功。仅出现3例轻微并发症，无严重并发症且无手术相关死亡。4例患者后来未行转流造口而接受了切除术，2例直肠癌患者术前行磁共振成像（MRI）和放疗。15例患者的手术被视为姑息性手术。4例患者出现支架移位，但未发生有症状的再梗阻，无患者需要后期手术。结肠直肠支架置入术有效且安全，可用于梗阻性癌症，既作为择期切除术前的临时缓解措施，也作为姑息性病例的确定性治疗方法。
