Turkyilmaz Atila, Eroglu Atilla, Aydin Yener, Kurt Aysel, Bilen Yusuf, Karaoglanoglu Nurettin
Department of Thoracic Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey.
Surg Laparosc Endosc Percutan Tech. 2010 Feb;20(1):10-5. doi: 10.1097/SLE.0b013e3181cdebf4.
At the present time, covered self-expandable metallic stent placement is the palliative treatment method for inoperable esophageal cancer. However, life-threatening early and late complications are seen related to esophageal stent placement. In this study, we discuss complications of esophageal stent placement with their management and present our own experience.
Between January 2000 and February 2009, 215 covered esophageal stent placements were performed in 174 inoperable esophageal cancer and/or esophagorespiratory fistula patients in the Department of Thoracic Surgery at the Ataturk University Hospital.
Major complications related to stent placement developed in 24 patients (11 bleeding, 6 aspiration pneumonia, 3 tracheal compressions, 2 perforations, and 2 esophagorespiratory fistulas). Two hundred and thirty minor complications were observed among 174 patients (165 chest pain, 29 tumoral overgrowth, 17 stent migration, 6 gastroesophageal reflux, 3 failure in stent placement, 3 hiccup, 2 foreign body sensation, 2 failure in stent expansion, 1 tumor ingrowth, 1 granulation tissue formation, and 1 food bolus obstruction). Reintervention was required in 56 (32.2%) patients who experienced complications. Stent-related mortality was seen in 4 (2.3%) patients (2 aspiration pneumonia, 1 tracheal compression, and 1 esophagorespiratory fistula). One hundred sixty-two of 174 patients died during follow up. The mean survival time was 177.3+/-59.3 days (range: 2 to 993 d).
The complication rate of self-expandable metallic stent placement is high in inoperable esophageal cancer patients. Although some of these complications are life threatening, many of them can be managed successfully with endoscopic reintervention.
目前，覆膜自膨式金属支架置入术是无法手术切除的食管癌的姑息治疗方法。然而，食管支架置入术会出现危及生命的早期和晚期并发症。在本研究中，我们讨论食管支架置入术的并发症及其处理方法，并介绍我们自己的经验。
2000年1月至2009年2月期间，阿塔图尔克大学医院胸外科对174例无法手术切除的食管癌和/或食管气管瘘患者进行了215次覆膜食管支架置入术。
24例患者出现与支架置入相关的主要并发症（11例出血、6例吸入性肺炎、3例气管受压、2例穿孔和2例食管气管瘘）。174例患者中观察到230例轻微并发症（165例胸痛、29例肿瘤过度生长、17例支架移位、6例胃食管反流、3例支架置入失败、3例打嗝、2例异物感、2例支架扩张失败、1例肿瘤长入、1例肉芽组织形成和1例食物团块梗阻）。56例（32.2%）出现并发症的患者需要再次干预。4例（2.3%）患者出现与支架相关的死亡（2例吸入性肺炎、1例气管受压和1例食管气管瘘）。174例患者中有162例在随访期间死亡。平均生存时间为177.3±59.3天（范围：2至993天）。
无法手术切除的食管癌患者行自膨式金属支架置入术的并发症发生率较高。虽然其中一些并发症危及生命，但许多并发症可通过内镜再次干预成功处理。
