Yamada Chizu, Ishikawa Fumihiko, Nitta Hiroshi, Fujita Yoshihisa, Omoto Hideyuki, Kamata Shigeyuki, Ito Hiroshi
Dept. of Surgery, Fukaya Red Cross Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2329-30.
Gastroduodenal stenting for gastric outlet obstruction (GOO) caused by malignant disease has been covered by health insurance in Japan since April 2010. We have inserted WallFlex™ duodenal stents (WDS) in 3 patients with GOO caused by unresectable advanced gastric cancer. WDS placement was successful with no complications in all cases. Mean treatment time was 44.7 (35-50) minutes, and mean survival time after WDS placement was 34.7 (19-51) days. Oral food intake was improved in all patients but 1. Enteroparalysis due to peritoneal metastasis supposedly voided WDS placement in 1 patient. WDS placement for GOO caused by advanced gastric cancer is expected to be a safe and effective palliative treatment but sometimes yields no benefit in the patient with peritoneal metastasis.
自2010年4月起，日本医疗保险已涵盖针对恶性疾病所致胃出口梗阻（GOO）的胃十二指肠支架置入术。我们为3例因无法切除的进展期胃癌导致GOO的患者置入了WallFlex™十二指肠支架（WDS）。所有病例中WDS置入均成功且无并发症。平均治疗时间为44.7（35 - 50）分钟，WDS置入后的平均生存时间为34.7（19 - 51）天。除1例患者外，所有患者的经口食物摄入量均有所改善。1例患者因腹膜转移导致的麻痹性肠梗阻可能不适于WDS置入。对于进展期胃癌所致GOO，WDS置入有望成为一种安全有效的姑息治疗方法，但对于腹膜转移患者有时可能并无益处。
