Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2010 Feb;25(2):234-43. doi: 10.1111/j.1440-1746.2009.06152.x.
Advances in stent design have led to a substantial increase in the use of stents for a variety of malignant and benign strictures in the gastrointestinal tract and biliary system. Whereas early stents were mostly composed of plastic, the majority of contemporary stents are self-expanding metal stents that are composed of either nitinol or stainless steel. These stents are able to exert an adequate expansile force and, at the same time, are highly flexible and biocompatible. Covered stents have been introduced to minimize tumor ingrowth through the metal mesh but are associated with higher rates for spontaneous migration. This has led to the development of covered stents with uncovered ends and stents with both covered and uncovered layers. Drug-eluting and biodegradable stents are also likely to become available in the near future. Although stents appear to be the preferred form of palliation for some patients with advanced cancer, many patients will benefit from a multidisciplinary approach that usually includes surgeons and oncologists.
支架设计的进步使得支架在胃肠道和胆道系统的各种恶性和良性狭窄中的应用大大增加。早期的支架主要由塑料制成，而大多数现代支架是自扩张金属支架，由镍钛诺或不锈钢制成。这些支架能够施加足够的扩张力，同时具有高度的柔韧性和生物相容性。为了最大限度地减少肿瘤通过金属网向内生长，已经引入了覆膜支架，但它们与自发迁移的发生率较高有关。这导致了开发具有未覆盖端的覆膜支架和具有覆盖层和未覆盖层的支架。载药和可生物降解支架也可能在不久的将来问世。虽然支架似乎是一些晚期癌症患者的首选姑息治疗形式，但许多患者将受益于多学科方法，通常包括外科医生和肿瘤学家。
