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自膨式金属支架用于梗阻性近端和远端大肠癌的安全性与有效性

Safety and efficacy of self-expandable metal stents for obstructive proximal and distal large bowel cancer.

作者信息

Mitra V, Hu M, Majumdar D, Krishnan V, Chaudhury B, Hancock J, Dwarakanath D

机构信息

V Mitra, James Cook University Hospital, Marton Rd, Middlesbrough TS4 3BW, UK. Email:

出版信息

J R Coll Physicians Edinb. 2017 Mar;47(1):30-34. doi: 10.4997/JRCPE.2017.107.

Abstract

Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction). The majority (88%) had self-expanded metal stents inserted for palliation. Technical and clinical success rates were 98.7% and 91.2%, respectively. One patient had stent-related perforation; there was no procedure-related mortality. Conclusion This study shows that self-expanded metal stent insertion in malignant colorectal obstruction is safe and effective and can be successfully delivered in a district general hospital with high technical and clinical success rates.

摘要

自膨式金属支架常用于治疗梗阻性大肠癌。本研究评估了在一家区综合医院进行结肠支架置入术的安全性和有效性。方法 对2007年1月1日至2014年2月28日期间接受恶性结直肠梗阻支架置入术的患者进行回顾性研究。结果 75例原发性结直肠癌患者(中位年龄75.2岁,70.6%为男性)接受了支架置入术——53例接受了半选择性自膨式金属支架置入术(用于亚急性肠梗阻),22例接受了急诊支架置入术(用于急性肠梗阻)。大多数(88%)患者因姑息治疗置入自膨式金属支架。技术成功率和临床成功率分别为98.7%和91.2%。1例患者发生支架相关穿孔;无手术相关死亡。结论 本研究表明,在恶性结直肠梗阻中置入自膨式金属支架是安全有效的,并且可以在区综合医院成功实施,技术成功率和临床成功率都很高。

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