Martinez Juan Carlos, Puc Matthew M, Quiros Roderick M
St. Luke's Hospital and Health Network, Bethlehem, PA 18015, USA.
ISRN Gastroenterol. 2011;2011:719575. doi: 10.5402/2011/719575. Epub 2011 Aug 8.
Esophageal cancer is often diagnosed at an advanced stage, with many patients found to have locoregional or metastatic disease at time of diagnosis. Because of this, cure may be unlikely, leading treatment efforts to focus more on symptom palliation and improving patient quality of life. The majority of patients with advanced disease suffer from some degree of dysphagia. Palliative efforts are therefore directed at relieving dysphagia, allowing patients to manage their oropharyngeal secretions, reduce aspiration risk, and maintain caloric intake orally. A variety of endoscopic treatment modalities have been utilized with these objectives in mind, with options determined by the location and size of the tumor, as well as the patient's expected prognosis. In this article, we review the use of endoscopically-placed stents for palliation in patients with advanced esophageal cancer. We discuss the history of stent use in such cases, as well as more recent developments in stent technology. We give an overview of some of the more commonly used stents in practice, discuss the technique of insertion, and survey the short- and long-term outcomes of stent placement.
食管癌通常在晚期才被诊断出来，许多患者在诊断时已出现局部区域或转移性疾病。因此，治愈可能不太可能，治疗重点更多地放在症状缓解和提高患者生活质量上。大多数晚期疾病患者都有一定程度的吞咽困难。因此，姑息治疗旨在缓解吞咽困难，使患者能够处理口咽分泌物，降低误吸风险，并通过口服维持热量摄入。为实现这些目标，人们采用了多种内镜治疗方式，具体选择取决于肿瘤的位置和大小以及患者的预期预后。在本文中，我们回顾了内镜下放置支架在晚期食管癌患者姑息治疗中的应用。我们讨论了此类病例中支架使用的历史以及支架技术的最新进展。我们概述了一些实际中更常用的支架，讨论了插入技术，并审视了支架置入的短期和长期结果。
