Padhan R K, Nongthombam S K, Venuthurimilli A, Dhingra R, Sahni P, Garg P K
Department of Gastroenterology, All Institute of Medical Sciences, New Delhi, India.
Department of Gastrointestinal Surgery, All Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2016 Oct-Dec;53(4):534-537. doi: 10.4103/0019-509X.204760.
Patients with unresectable esophageal cancer require palliation for dysphagia. Placement of a self-expandable metal stent (SEMS) is the procedure of choice for palliation of dysphagia.
To evaluate the safety and efficacy of an indigenous fully-covered SEMS in patients with esophageal cancer.
Eligible patients with unresectable esophageal cancer requiring palliation for dysphagia were included in the study. An indigenous fully covered SEMS of appropriate length was placed under endoscopic and fluoroscopic guidance. Outcome measures assessed were adverse events and improvement in dysphagia.
Twenty one patients (mean age 57.71±13.14 years; 17 males) were included. After stenting, dysphagia score decreased from 3.2+0.4 to 0.35+0.74 at 4 weeks. Adverse events included retrosternal pain, respiratory distress and aspiration pneumonia in 12, 2 and 1 patients respectively. Five patients required repeat stenting due to stent migration in 4 (following radiotherapy in 3) and tumour ingrowth in 1. There was primary stent malfunction in one patient. The median survival of patients was 140 (76-199) days, which was higher in those who received radiotherapy.
The stent was reasonably safe and effective to relieve dysphagia due to unresectable esophageal cancer.
无法切除的食管癌患者需要缓解吞咽困难。放置自膨式金属支架（SEMS）是缓解吞咽困难的首选方法。
评估国产全覆膜SEMS在食管癌患者中的安全性和有效性。
符合条件的无法切除的食管癌且需要缓解吞咽困难的患者纳入本研究。在内镜和透视引导下放置合适长度的国产全覆膜SEMS。评估的结果指标为不良事件和吞咽困难的改善情况。
纳入21例患者（平均年龄57.71±13.14岁；男性17例）。置入支架后，4周时吞咽困难评分从3.2 + 0.4降至0.35 + 0.74。不良事件分别包括12例胸骨后疼痛、2例呼吸窘迫和1例吸入性肺炎。5例患者因支架移位（3例为放疗后）4例和肿瘤向内生长1例而需要再次置入支架。1例患者出现原发性支架功能障碍。患者的中位生存期为140（76 - 199）天，接受放疗的患者生存期更长。
该支架在缓解无法切除的食管癌所致吞咽困难方面具有合理的安全性和有效性。
