Endoscopy Unit, Barwon Health, Geelong, VIC 3220, Australia.
J Oncol. 2013;2013:167851. doi: 10.1155/2013/167851. Epub 2013 Nov 10.
Background. Self-expandable metal stents (SEMs) are increasingly being utilised instead of invasive surgery for the palliation of patients with malignant gastroduodenal outlet obstruction. Aim. To review two tertiary centres' experience with placement of SEMs and clinical outcomes. Methods. Retrospective analysis of prospectively collected data over 12 years. Results. Ninety-four patients (mean age, 68; range 28-93 years) underwent enteral stenting during this period. The primary tumour was gastric adenocarcinoma in 27 (29%) patients, pancreatic adenocarcinoma in 45 (48%), primary duodenal adenocarcinoma in 8 (9%), and cholangiocarcinoma and other metastatic cancers in 14 (16%). A stent was successfully deployed in 95% of cases. There was an improvement in gastric outlet obstruction score (GOOS) in 84 (90%) of patients with the ability to tolerate an enteral diet. Median survival was 4.25 months (range 0-49) without any significant differences between types of primary malignancy. Mean hospital stay was 3 days (range 1-20). Reintervention rate for stent related complications was 5%. Conclusion. The successful deployment of enteral stents achieves excellent palliation often resulting in the prompt reintroduction of enteral diet and early hospital discharge with minimal complications and reintervention.
自膨式金属支架（SEMs）越来越多地被用于缓解恶性胃十二指肠出口梗阻患者，而非采用侵入性手术。目的：回顾两个三级中心在 SEM 放置和临床结果方面的经验。方法：对 12 年来前瞻性收集的数据进行回顾性分析。结果：在此期间，94 名患者（平均年龄 68 岁；年龄范围 28-93 岁）接受了肠内支架置入。27 名（29%）患者的原发性肿瘤为胃腺癌，45 名（48%）为胰腺腺癌，8 名（9%）为原发性十二指肠腺癌，14 名（16%）为胆管癌和其他转移性癌症。95%的病例成功部署了支架。84 名（90%）患者的胃出口梗阻评分（GOOS）得到改善，能够耐受肠内饮食。中位生存时间为 4.25 个月（范围 0-49），不同类型的原发性恶性肿瘤之间无显著差异。平均住院时间为 3 天（范围 1-20）。支架相关并发症的再介入率为 5%。结论：肠内支架的成功部署可实现出色的缓解效果，通常可迅速重新引入肠内饮食，并尽早出院，且并发症和再介入较少。
