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食管支架置入并发症在食管癌姑息性治疗吞咽困难中的评价。

The evaluation of esophageal stenting complications in palliative treatment of dysphagia related to esophageal cancer.

机构信息

Gastrointestinal Endoscopy Laboratory, WAM University Hospital, Medical University of Lodz, Lodz, Poland.

出版信息

Med Sci Monit. 2012 May;18(5):CR323-9. doi: 10.12659/msm.882739.

Abstract

BACKGROUND

Esophageal cancer is the seventh-most frequent cause of cancer-related deaths and it is usually diagnosed at an inoperable stage. In palliative treatment, endoscopic and non-endoscopic methods are applied to reduce dysphagia in patients with neoplastic esophageal obstruction. Because of severe complications, non-endoscopic treatment (surgery, radiotherapy, brachytherapy and chemotherapy) is applied rarely. Within the endoscopic methods, only the use of endoprostheses yields long-term effects. The aim of this study was to evaluate the safety and efficacy of implantation of self-expandable esophageal stents in palliative treatment of dysphagia related to esophageal cancer.

MATERIAL/METHODS: A total number of 46 patients (41 males and 5 females) were qualified to palliative implantation of coated self-expandable stent. The mean age of the patients was 67 years (from 51 to 78 years). In all patients, Evolution-type coated self-expandable stents were used. In all cases, 24 hours after the implantation, radiological examination was performed to assess the stent location.

RESULTS

Severe, possibly life-threatening, complications constituted 28% of all the complications and occurred in 9% of the patients. Less severe complications occurred in 17% of the observed patients and were not life-threatening.

CONCLUSIONS

In patients with neoplastic esophageal stenosis, stenting with coated, self-expandable nitinol prostheses is a safe, effective and fast method of palliative dysphagia treatment.

摘要

背景

食管癌是第七大常见癌症死因,通常在无法手术的阶段被诊断出来。在姑息治疗中,采用内镜和非内镜方法来减轻肿瘤性食管梗阻患者的吞咽困难。由于严重的并发症,很少应用非内镜治疗(手术、放疗、近距离放疗和化疗)。在内镜方法中,只有使用内支架才能产生长期效果。本研究旨在评估自膨式食管支架在姑息治疗食管癌相关吞咽困难中的安全性和疗效。

材料/方法:共有 46 名患者(41 名男性和 5 名女性)符合姑息性植入涂层自膨式支架的条件。患者的平均年龄为 67 岁(51 至 78 岁)。所有患者均使用 Evolution 型涂层自膨式支架。所有病例均在植入后 24 小时进行放射学检查,以评估支架位置。

结果

严重的、可能危及生命的并发症占所有并发症的 28%,发生在 9%的患者中。观察到的 17%的患者发生了较轻的并发症,但没有生命危险。

结论

在患有肿瘤性食管狭窄的患者中,用涂层自膨式镍钛合金支架进行支架置入是一种安全、有效、快速的姑息性吞咽困难治疗方法。

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