Gottlieb J, Wedemeyer J
Klinik für Pneumologie/OE 6870, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Deutschland.
Internist (Berl). 2010 Mar;51 Suppl 1:237-45. doi: 10.1007/s00108-009-2502-z.
Luminal obstruction from tumor growth can in relation to bronchial carcinoma lead to airway and/or esophageal obstruction in breathlessness or swallowing difficulties respectively. Self-expanding stents have become an established method of restoring luminal patency in both the esophagus and central airways, leading to significant symptomatic improvement. Due to anatomical constraints particularly in processes around the tracheal carina, stent implantation within the bronchial system often poses greater difficulty than within the esophagus. Technical difficulties do however arise in the esophagus, specifically in relation to stenotic high-cervical tumors, as well as distal stenosis. In this regard, advances in stent development have resulted in significantly improved outcomes with modern stents. In high-cervical esophageal tumors as well as locally invasive tumors with evidence of tracheobronchial fistulae a shared interdisciplinary care between the gastroenterology and pulmonary teams is necessary for a satisfactory outcome.
肿瘤生长引起的管腔阻塞与支气管癌相关时,可分别导致气道阻塞和/或食管阻塞,从而引起呼吸困难或吞咽困难。自膨式支架已成为恢复食管和中央气道管腔通畅的既定方法,可显著改善症状。由于解剖学限制,特别是在气管隆突周围的操作中,支气管系统内的支架植入通常比食管内的支架植入难度更大。然而,食管内也会出现技术难题,特别是与高位颈段狭窄肿瘤以及远端狭窄有关的问题。在这方面,支架技术的进步已使现代支架的治疗效果得到显著改善。对于高位颈段食管肿瘤以及有气管支气管瘘证据的局部浸润性肿瘤,胃肠病学和肺部团队之间的跨学科联合护理对于取得满意的治疗效果是必要的。