Department of Radiology, Kyung Hee University Medical Center, 1 Heoki-dong Dongdaemun-gu, Seoul 130-702, Korea.
J Vasc Interv Radiol. 2010 Aug;21(8):1244-9. doi: 10.1016/j.jvir.2010.04.009. Epub 2010 Jul 3.
To evaluate the effectiveness of radiologic placement of uncovered stents for the treatment of malignant colorectal obstruction.
From May 2003 to January 2008, 116 radiologic placements of uncovered stents were attempted in 99 patients (M:F, 59:40; mean age, 65 years) with malignant colorectal obstructions. The location of stent insertion, technical and clinical success, complication rates, and patency rates of the stents in a palliative group were also evaluated. In the palliative group, the follow-up period was 2-455 days (mean, 100 +/- 129 days).
Radiologic stent placement was technically successful in 110 of 116 cases (94.8%). Fifty cases of stent placement were preoperative (45.5%, 50 of 110) and 60 (54.5%, 60 of 110) were performed with palliative intents. In five of six failed cases, the replacement of the stent was later performed with the assistance of colonoscopy. One patient underwent an emergency operation. In 98 of 110 cases, the symptoms of obstruction were relieved, for a clinical success rate of 89.1%. Of the 50 stents that were placed successfully with preoperative intent, 44 patients underwent surgery within a mean of 10.3 days. In the palliative group, the patency rates were 89.7% at 1 month, 85.6% at 3 months, 80.8% at 6 months, and 72.7% at 12 months.
The radiologic placement of uncovered stents for the treatment of malignant colorectal obstruction is feasible and safe and provides acceptable clinical results not only for preoperative decompression but also for palliative cases, especially in left-sided colonic obstructions.
评估经放射学方法置入无覆膜支架治疗恶性结直肠梗阻的效果。
2003 年 5 月至 2008 年 1 月，99 例恶性结直肠梗阻患者（男/女，59/40；平均年龄 65 岁）共行 116 次放射学无覆膜支架置入术。评估支架置入部位、技术和临床成功率、并发症发生率以及姑息组支架的通畅率。在姑息组中，随访时间为 2-455 天（平均 100 +/- 129 天）。
116 例中有 110 例（94.8%）技术上成功放置了放射学支架。50 例术前（45.5%，50/110），60 例姑息性（54.5%，60/110）。在 6 例失败病例中，有 5 例后来在结肠镜的协助下更换了支架。1 例患者行急诊手术。在 110 例中有 98 例（89.1%）梗阻症状缓解，临床成功率为 89.1%。50 例术前成功放置支架的患者中，44 例平均在 10.3 天内行手术治疗。在姑息组中，1 个月时的通畅率为 89.7%，3 个月时为 85.6%，6 个月时为 80.8%，12 个月时为 72.7%。
经放射学方法置入无覆膜支架治疗恶性结直肠梗阻是可行且安全的，不仅可为术前减压，而且可为姑息治疗提供可接受的临床效果，特别是在左侧结肠梗阻中。
