Baerlocher Mark Otto, Asch Murray R, Vellahottam Andrew, Puri Gaurav, Andrews Karen, Myers Andy
Radiology Residency Training Program, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Can J Surg. 2008 Apr;51(2):130-4.
Increasing scientific evidence supports the use of self-expanding metallic gastrointestinal (GI) stents. The commonly accepted primary indications are their usefulness as a bridge to surgery and for palliation to avoid surgery. These stents have been shown to have high technical success and low complication rates, leading to improved quality of life for patients. They have also been shown to be cost-effective when compared with alternative therapies. The objective of this study is to present a retrospective review of our local experience.
Attempts were made to place 23 GI stents in 16 patients for palliative cancer indications.
Follow-up was 5-352 days (mean 81.9 d). Presenting symptoms included abdominal distention or pain (81%), nausea or vomiting (69%), constipation (31%) and weight loss (19%). Stents were placed in the colon (11 patients), duodenum (4 patients) or esophagus (1 patient). The technical success rate was 91.3%, the clinical success rate (defined as any improvement in symptoms in patients successfully receiving a stent) was 85.7%, and the complication rate was 21.4% among patients successfully receiving a stent, or 18.8% overall. Of 14 patients successfully receiving at least 1 stent, 10 (71%) were discharged home after a mean of 11.5 days (range 1-26 d). Of patients successfully receiving at least 1 stent, 12 (86%) had passed away at the time of last follow-up. Patients who successfully received a stent but who have since passed away (either in hospital or out of hospital) had their stent(s) in situ for a mean of 57 days (range 5-180 d).
On the basis of our data, we believe that GI stents may be safely and effectively used in a community hospital setting and that they provide benefit in the palliative care population.
越来越多的科学证据支持使用自膨式金属胃肠道（GI）支架。普遍认可的主要适应证是其作为手术过渡手段以及用于姑息治疗以避免手术的效用。这些支架已显示出技术成功率高且并发症发生率低，从而改善了患者的生活质量。与替代疗法相比，它们还被证明具有成本效益。本研究的目的是对我们当地的经验进行回顾性分析。
尝试为16例因癌症姑息治疗适应证的患者置入23枚GI支架。
随访时间为5 - 352天（平均81.9天）。出现的症状包括腹胀或腹痛（81%）、恶心或呕吐（69%）、便秘（31%）和体重减轻（19%）。支架置入部位为结肠（11例患者）、十二指肠（4例患者）或食管（1例患者）。技术成功率为91.3%，临床成功率（定义为成功置入支架的患者症状有任何改善）为85.7%，在成功置入支架的患者中并发症发生率为21.4%，总体并发症发生率为18.8%。在14例成功置入至少1枚支架的患者中，10例（71%）在平均11.5天（范围1 - 26天）后出院回家。在成功置入至少1枚支架的患者中，12例（86%）在最后一次随访时已去世。成功置入支架但后来去世（无论是在医院还是院外）的患者，其支架在位平均时间为57天（范围5 - 180天）。
根据我们的数据，我们认为GI支架可在社区医院环境中安全有效地使用，并且它们对姑息治疗人群有益。
