Imperial College Healthcare Trust, London, UK.
Curr Opin Support Palliat Care. 2012 Mar;6(1):27-32. doi: 10.1097/SPC.0b013e32834f6004.
This review will discuss the immediate- and long-term success, complications and overall benefits of self-expandable metal stents (SEMSs) in malignant or benign obstruction of the oesophagus, stomach and duodenum. Over recent years, indications such as benign disease have expanded, as has SEMS diversity with self-expandable plastic stents (SEPSs) or fully covered and biodegradable stents, for example.
SEMSs have been increasingly used in malignant upper gastrointestinal obstruction with many reports confirming efficacy, despite a significant complication rate. Fully covered stents are increasingly used for a variety of benign oesophageal disease, but their place in gastric outlet obstruction is still unclear. Covered and uncovered stents have different functional characteristics and stent type must be selected on an individual basis. Biodegradable stents show promise and the outcome of experience in larger patient cohorts is eagerly awaited.
This area is an evolving field, in which the clinician requires up-to-date knowledge of therapeutic options to make individualized treatment choices in difficult clinical circumstances. Technical and clinical success for oesophageal or gastroduodenal SEMSs are then above 90%. Minor complications are common, but serious complications seldom occur. Biodegradable stents may be useful, especially when stenting is needed for a short period of time.
本文将讨论自膨式金属支架（SEMS）在食管、胃和十二指肠良恶性梗阻中的近期和长期成功率、并发症及总体获益。近年来，SEMS 的适应证已扩大，例如良性疾病，SEMS 的种类也在增加，包括自膨式塑料支架（SEPS）或全覆膜可降解支架等。
尽管并发症发生率较高，但越来越多的恶性上消化道梗阻患者使用 SEMS，其疗效已得到多项报道证实。全覆膜支架越来越多地用于各种良性食管疾病，但在胃出口梗阻中的地位仍不明确。覆膜和无覆膜支架具有不同的功能特点，必须根据个体情况选择支架类型。可降解支架具有广阔的应用前景，人们迫切期待更大患者队列的经验结果。
该领域是一个不断发展的领域，临床医生需要了解最新的治疗选择，以便在困难的临床情况下做出个体化的治疗决策。食管或胃十二指肠 SEMS 的技术和临床成功率均超过 90%。常见轻微并发症，但严重并发症很少发生。可降解支架可能有用，特别是在需要短期支架置入的情况下。
