Szegedi László, Gál István, Kósa Imre, Kiss Gyula G
2nd Department of Internal Medicine, Kenézy Gyula Teaching Hospital, Debrecen, Hungary.
Eur J Gastroenterol Hepatol. 2006 Nov;18(11):1197-201. doi: 10.1097/01.meg.0000236886.67085.2e.
The use of self-expandable plastic stents has offered a reasonable alternative of self-expandable metal stents in palliative treatment of esophageal malignancies, in the recent years. Studies and clinical data on the use of self-expandable plastic stents in esophageal cancer are, however, available in a very limited number. Here, we present the results of our 3-year study designed to evaluate the efficacy of self-expandable plastic stents in palliation of advanced esophageal carcinoma.
Between January 2001 and February 2004, 69 patients with advanced nonoperable esophageal cancer were enrolled in the study and followed up until their death, after insertion of Polyflex self-expandable plastic stents. Dysphagia scores, Karnofsky indices and body weights were determined and compared in order to evaluate the effect of the stent insertion on general status and well-being of the patients.
Insertion of Polyflex self-expandable plastic stents and covered self-expandable metal stents was performed in 66 cases and in eight cases, respectively; in certain patients, owing to complications, more than one stent had to be inserted. In all cases, the insertion of stents has been performed without major complication and it has led to an instant improvement in swallowing and dysphagia scores. The rates of tumoral overgrowth and of stent migration were low. The mean follow-up time of our patients was 129 days (10-312 days).
In concordance with previous studies, according to our results, the use of self-expandable plastic stents in palliation of esophageal cancer seems to be safe and effective in improving the quality of life of these patients.
近年来,自膨式塑料支架在食管癌的姑息治疗中已成为自膨式金属支架的一种合理替代方案。然而,关于自膨式塑料支架在食管癌治疗中的研究和临床数据非常有限。在此,我们展示了一项为期3年的研究结果,该研究旨在评估自膨式塑料支架在晚期食管癌姑息治疗中的疗效。
2001年1月至2004年2月期间,69例晚期不可手术食管癌患者纳入本研究,在植入Polyflex自膨式塑料支架后进行随访直至死亡。测定并比较吞咽困难评分、卡氏指数和体重,以评估支架植入对患者总体状况和生活质量的影响。
分别有66例和8例患者植入了Polyflex自膨式塑料支架和覆膜自膨式金属支架;在某些患者中,由于并发症,不得不植入多个支架。所有病例中,支架植入均未出现严重并发症,且吞咽和吞咽困难评分立即得到改善。肿瘤过度生长和支架移位的发生率较低。患者的平均随访时间为129天(10 - 312天)。
与之前的研究一致,根据我们的结果,自膨式塑料支架在食管癌姑息治疗中似乎对改善这些患者的生活质量是安全有效的。