Drepper M, Bichard P, Frossard J-L
Service de gastroentérologie et d'hépatologie, Département des spécialités de médecine HUG, 1211 Genève 14.
Rev Med Suisse. 2013 Sep 4;9(396):1590-3.
About 20% of colorectal cancers are complicated by intestinal obstruction. Self-expanding metallic stents (SEMS) permit desobstruction in over 90% of cases. In palliative setting, employing SEMS reduces hospitalisation time and permanent stoma rate with identical mortality rates compared to surgery. When using SEMS as bridge to surgery, higher primary and lower overall stoma rates are obtained with no significant mortality reduction by now. Of concern, procedure-related bowel perforation is frequent, especially among endoscopists lacking sufficient experience in colonic stenting.
约20%的结直肠癌会并发肠梗阻。自膨式金属支架（SEMS）在超过90%的病例中可实现解除梗阻。在姑息治疗中，与手术相比，使用SEMS可缩短住院时间并降低永久性造口率，死亡率相同。当将SEMS用作手术桥梁时，目前虽未显著降低死亡率，但可获得更高的一期造口率和更低的总体造口率。令人担忧的是，与操作相关的肠穿孔很常见，尤其是在缺乏足够结肠支架置入经验的内镜医师中。
