Kim Jin Hyoung, Song Ho-Young, Li Yong-Dong, Shin Ji Hoon, Park Jung-Hoon, Yu Chang-Sik, Kim Jin Cheon
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea.
AJR Am J Roentgenol. 2009 Jul;193(1):248-54. doi: 10.2214/AJR.08.2003.
The purpose of this study was to compare, focusing on colonic perforation and stent migration, the clinical safety and efficacy of dual-design expandable colorectal stents with flared ends with those of stents with bent ends in the treatment of patients with malignant colorectal obstruction.
A total of 122 patients with malignant colorectal obstruction underwent implantation of dual-design stents with flared (n = 69) or bent (n = 53) ends.
Stent placement was technically successful in 116 of 122 patients (95.1%), 65 of 69 patients (94.2%) with flared-end stents and 51 of 53 patients (96.2%) with bent-end stents (p > 0.05). Clinical success was achieved within 2 days in 61 of 65 patients (93.8%) with bent-end stents and in 46 of 51 patients (90.2%) with flared-end stents (p > 0.05). Complications included seven cases of colonic perforation (6%), seven cases of stent migration (6%), three cases of tumor overgrowth (2.6%), four cases of severe rectal pain (3.4%), and four cases of bleeding (3.4%). There were no significant differences between the rates of colonic perforation and stent migration in the two groups (6.2% vs 5.9%), and the overall complication rates were similar (p > 0.05).
Dual-design expandable colorectal stents with flared ends and those with bent ends are equally safe and effective, having similar perforation and migration rates.
本研究旨在聚焦结肠穿孔和支架移位,比较双设计可扩张结直肠支架(喇叭口端)与弯角端支架在治疗恶性结直肠梗阻患者中的临床安全性和有效性。
总共122例恶性结直肠梗阻患者接受了喇叭口端(n = 69)或弯角端(n = 53)双设计支架植入。
122例患者中有116例(95.1%)支架置入技术成功,其中喇叭口端支架69例中有65例(94.2%)成功,弯角端支架53例中有51例(96.2%)成功(p>0.05)。弯角端支架65例中有61例(93.8%)在2天内取得临床成功,喇叭口端支架51例中有46例(90.2%)在2天内取得临床成功(p>0.05)。并发症包括7例结肠穿孔(6%)、7例支架移位(6%)、3例肿瘤过度生长(2.6%)、4例严重直肠疼痛(3.4%)和4例出血(3.4%)。两组结肠穿孔和支架移位发生率无显著差异(6.2%对5.9%),总体并发症发生率相似(p>0.05)。
喇叭口端双设计可扩张结直肠支架和弯角端双设计可扩张结直肠支架同样安全有效,穿孔和移位发生率相似。