Department of Thoracic Surgery, Trakya University Medical Faculty, Edirne, Turkey.
Dis Esophagus. 2010 Sep;23(7):561-4. doi: 10.1111/j.1442-2050.2010.01046.x. Epub 2010 Mar 8.
We report our experience with self-expandable metallic stents for the palliation of malignant dysphagia and tracheoesophageal fistulae caused by lung cancer. Esophageal self-expandable metallic stents were deployed in 28 patients with malignant dysphagia as a result of lung cancer between August 2002 and January 2009. Mean age was 62.1 (42-77) with 26 male patients. Twenty-three patients received previous chemo-radiotherapy and two had pneumonectomy. Tracheoesophageal fistulae were coexisting in eight patients. Stents were inserted under fluoroscopic control over guide-wire with the patient under conscious sedation. One stent was used in all patients except one fistula patient with two stents. Immediate improvement after stent insertion was seen in all patients. Fistulae were sealed off in all. No complication was seen except transitional pain in 12 patients (42%). During the follow-up, all patients remained asymptomatic with no clinical appearance of dysphagia symptoms except one patient whom gastrostomy was applied. All patients with fistulae died with a mean survival of 15.4 weeks. Dysphagia patients without fistulae died with mean survival of 6 months except one patient with 1 month follow-up. Self-expandable esophageal metallic stent insertion can manage malignant dysphagia in lung cancer patients with significant survival period via nonsurgical approach.
我们报告了我们使用自膨式金属支架治疗肺癌引起的恶性吞咽困难和气管食管瘘的经验。2002 年 8 月至 2009 年 1 月期间，我们对 28 例因肺癌导致恶性吞咽困难的患者使用了食管自膨式金属支架。平均年龄为 62.1 岁（42-77 岁），其中 26 例为男性患者。23 例患者接受了化疗和放疗，2 例患者接受了肺切除术。8 例患者同时存在气管食管瘘。在患者接受清醒镇静的情况下，在透视引导下用导丝将支架插入。除 1 例瘘管患者使用 2 个支架外，所有患者均使用 1 个支架。所有患者在支架插入后立即得到改善。所有瘘管均被封闭。除 12 例患者（42%）出现过渡性疼痛外，无其他并发症。在随访期间，所有患者均无症状，无吞咽困难症状，除 1 例患者接受了胃造口术。所有无瘘管的吞咽困难患者的平均生存时间为 6 个月，除 1 例随访 1 个月的患者外。通过非手术方法，自膨式食管金属支架置入可治疗肺癌患者的恶性吞咽困难，并获得显著的生存时间。
