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[不可切除的食管癌和贲门癌的修复治疗:7例报告]

[Prosthetic treatment in inoperable cancers of the oesophagus and cardia: a report of 7 cases].

作者信息

Giordano Giuseppe, Rendine Roberto, Stoppino Vincenzo, Germano Mario Pio, Bax Maria Maddalena, Milillo Paola, Fruscio Lorenzo, Fabrizio Michele, Ricco Anna Maria

机构信息

Cattedra di Chirurgia Generale (indirizzo oncologico), Università degli Studi di Foggia, Scuola di Specializzazione in Chirurgia dell'Apparato digerente ed Endoscopia digestiva.

出版信息

Chir Ital. 2005 Jul-Aug;57(4):457-64.

Abstract

The Authors report their personal experience with 9 patients affected by cardial cancer and 4 with medio-distal oesophageal cancer, treated at the Department of Surgical Sciences of the University of Foggia. Of the 9 patients with cardial cancers, 4 were submitted to total gastrectomy; while the other 5, who had clearly inoperable forms, were fitted with a self-expanding metal prosthesis (Ultraflex). Of the 4 cases with medio-distal oesophageal cancers, which were considered beyond any kind of surgical treatment, 2 (with stenosing forms) were fitted with the self-expanding prosthesis (Ultraflex), while the other 2 (with friable, bleeding tissue) were treated by laser therapy with all the drawbacks such treatment entails. After application of stents, dysphagia decreases and on the whole we obtain real functional success and a better quality of life. Furthermore, the percentage of acute complications such as profuse bleeding, perforation of the pharynx or migration of the prosthesis and late complications such as obstruction by food, neoplastic obstruction, or haemorrhage is marginal. Finally, the ease of application and the economic saving achieved (due to reduction in hospitalisation time and charges) confer undeniable additional advantages on the procedure.

摘要

作者报告了他们在福贾大学外科学系治疗的9例贲门癌患者和4例中下段食管癌患者的个人经验。在9例贲门癌患者中,4例行全胃切除术;而另外5例,其病情明显无法手术,安装了自膨式金属支架(Ultraflex)。在4例被认为无法进行任何手术治疗的中下段食管癌患者中,2例(狭窄型)安装了自膨式支架(Ultraflex),而另外2例(组织脆弱、易出血)接受了激光治疗,但这种治疗有诸多弊端。放置支架后,吞咽困难减轻,总体上我们获得了真正的功能改善和更好的生活质量。此外,诸如大量出血、咽部穿孔或支架移位等急性并发症以及诸如食物梗阻、肿瘤性梗阻或出血等晚期并发症的发生率很低。最后,该操作的易于实施以及所实现的经济节省(由于住院时间和费用的减少)赋予了该手术不可否认的额外优势。

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