Lew Ronald J, Shah Janak N, Chalian Ara, Weber Randal S, Williams Noel N, Kochman Michael L
Division of Gastroenterology, Department of Medicine, Hospital of the University of Pennsylvania, Division of Gastroenterology, 3400 Spruce Street, 3 Ravdin Building, Philadelphia, Pennsylvania 19104, USA.
Head Neck. 2004 Feb;26(2):179-83. doi: 10.1002/hed.10365.
Complete esophageal stenosis can occur after external beam radiation therapy for malignancies. Treatment for this complication has traditionally involved surgery.
A new technique to reestablish luminal patency is described. This minimally invasive technique involves retrograde endoscopy by means of gastrostomy tube tract and puncture of the stenotic occlusion followed by stricture dilatation. The procedure is performed under combined endoscopic and laryngoscopic guidance.
Five consecutive patients who had complete esophageal stenoses develop after radiation therapy for malignant disease underwent retrograde endoscopy by way of gastrostomy tube tracts. Stenoses were punctured under endoscopic and laryngoscopic guidance with guide wires. Strictures were dilated with wire-guided balloons or polyvinyl dilators. Luminal patency was established in all patients using this technique without procedural complications.
Endoscopic retrograde puncture and dilatation of total esophageal stenoses is safe, effective, and useful to reestablish luminal patency for radiation-induced strictures. This technique should be attempted before more invasive treatments.
恶性肿瘤外照射放疗后可发生完全性食管狭窄。传统上对该并发症的治疗方法是手术。
描述了一种重建管腔通畅的新技术。这种微创技术包括通过胃造瘘管通道进行逆行内镜检查，穿刺狭窄闭塞部位，随后进行狭窄扩张。该操作在内镜和喉镜联合引导下进行。
5例因恶性疾病放疗后发生完全性食管狭窄的患者连续接受了经胃造瘘管通道的逆行内镜检查。在内镜和喉镜引导下用导丝穿刺狭窄部位。用导丝引导的球囊或聚乙烯扩张器扩张狭窄部位。使用该技术在所有患者中均建立了管腔通畅，且无手术并发症。
内镜逆行穿刺和扩张完全性食管狭窄对于重建放疗引起的狭窄的管腔通畅是安全、有效且有用的。在进行更具侵入性的治疗之前应尝试该技术。
