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自膨式金属支架治疗无法切除的IVB期结直肠癌所致结肠梗阻的疗效

The efficacy of self-expanding metal stents for colorectal obstruction with unresectable stage IVB colorectal cancer.

作者信息

Kim Jung Ho, Kim Yoon Jae, Lee Jong Joon, Chung Jun Won, Kwon Kwang An, Park Dong Kyun, Kim Ju Hyun, Hahm Ki Baik

机构信息

Department of Gastroenterology, Gachon University, Incheon, Korea.

出版信息

Hepatogastroenterology. 2012 Nov-Dec;59(120):2472-6. doi: 10.5754/hge12139.

Abstract

BACKGROUND/AIMS: Acute colorectal obstruction with stage IVB colorectal cancer has a poor prognosis and short life expectancy. The effectiveness of self-expanding metal stents (SEMS) has been demonstrated in colorectal cancer patients with obstruction. However, little is known about the palliative efficacy of stent placement inpatients with unresectable colorectal cancer.

METHODOLOGY

The medical records of patients who received SEMS for stage IVB colorectal cancer with acute colorectal obstruction between March 2004 and July 2010 were retrospectively reviewed. A total of 24 patients with unresectable Stage IVB colorectal cancer with acute colorectal obstruction were enrolled in this study.

RESULTS

Twenty-four patients received SEMS placement during the study period. The mean age of the patients was 63.0 years (range 35-84 years). Fifteen patients were male and nine were female. The most common obstructive lesion was in the sigmoid colon (70.8%), including the sigmoid-descending and rectosigmoid junctions. Un-covered SEMS were used in 62.5% of patients. On the first attempt, the technical success rate of SEMS was 95.8%. The estimated duration of primary stent patency and overall survival periods after SEMS were 332.0 and 231.8 days, respectively.

CONCLUSIONS

SEMS insertion may be a useful therapeutic choice for acute colorectal obstruction in patients with unresectable stage IVB colorectal cancer.

摘要

背景/目的:IVB期结直肠癌合并急性结直肠梗阻预后较差,预期寿命短。自膨式金属支架(SEMS)在结直肠癌梗阻患者中的有效性已得到证实。然而,对于不可切除的结直肠癌患者,支架置入的姑息疗效知之甚少。

方法

回顾性分析2004年3月至2010年7月期间因IVB期结直肠癌合并急性结直肠梗阻接受SEMS治疗的患者的病历。本研究共纳入24例不可切除的IVB期结直肠癌合并急性结直肠梗阻患者。

结果

研究期间24例患者接受了SEMS置入。患者的平均年龄为63.0岁(范围35 - 84岁)。15例为男性,9例为女性。最常见的梗阻部位是乙状结肠(70.8%),包括乙状结肠-降结肠和直肠乙状结肠交界处。62.5%的患者使用了未覆膜的SEMS。首次尝试时,SEMS的技术成功率为95.8%。SEMS置入后,主要支架通畅的估计持续时间和总生存期分别为332.0天和231.8天。

结论

对于不可切除的IVB期结直肠癌合并急性结直肠梗阻患者,SEMS置入可能是一种有用的治疗选择。

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