Didden P, Spaander M C W, Bruno M J, Kuipers E J
Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Curr Gastroenterol Rep. 2013 Apr;15(4):319. doi: 10.1007/s11894-013-0319-3.
Endoscopic stent placement is an effective palliative treatment for malignant dysphagia and fistula, leading to rapid symptom relief. However, recurrent dysphagia and other stent-related complications are common, for which reason continuously new design modifications are implemented. Although some of these changes facilitate stent placement, complications remain and occur at similar rates. Recently, stents have also been used in benign esophageal disorders. Covered stents have the ability to effectively seal esophageal perforations and leaks, reducing the need for invasive surgery. This benefit does not pertain to patients with refractory benign esophageal strictures, in whom stents have limited long-term effect and are associated with a high complication rate. The initial results of fully covered metal stents in refractory esophageal variceal bleeding are encouraging, but their definite role remains to be further elucidated. This review provides an overview of indications, techniques, and management of complications of stents in malignant and benign esophageal disease.
内镜下支架置入术是治疗恶性吞咽困难和瘘的一种有效姑息治疗方法，可迅速缓解症状。然而，复发性吞咽困难和其他与支架相关的并发症很常见，因此不断有新的设计改进。尽管其中一些改变便于支架置入，但并发症仍然存在，且发生率相似。最近，支架也被用于良性食管疾病。覆膜支架能够有效封闭食管穿孔和渗漏，减少侵入性手术的需求。对于难治性良性食管狭窄患者，这一益处并不适用，因为支架在这些患者中远期效果有限且并发症发生率高。全覆膜金属支架用于难治性食管静脉曲张出血的初步结果令人鼓舞，但其确切作用仍有待进一步阐明。本综述概述了支架在恶性和良性食管疾病中的适应证、技术及并发症处理。
