Rana Fahd, Dhar Anjan
Department of Gastroenterology, County Durham & Darlington NHS Foundation Trust, Darlington, Co. Durham, UK.
Frontline Gastroenterol. 2015 Apr;6(2):94-100. doi: 10.1136/flgastro-2015-100559. Epub 2015 Mar 6.
Oesophageal stenting is now standard treatment for managing both benign and malignant stenosis of the oesophagus. There is a wide choice in oesophageal stents currently available on the market, with variations in the stent material, size and design. Most oesophageal stents are made from metal alloy compounds for use in malignant strictures, although there are stents made of durable polymers, and now of biodegradable (BD) material, for use in both benign and malignant strictures. With the development of self-expanding plastic stents, self-expanding metal stents and BD stents, stent placement for oesophageal pathologies can be safe and cost-effective. Oesophageal stenting has several challenges for a therapeutic endoscopist which is determined by the location of stricture or tumour, the anatomy of the stenosis and the nature of stent selected. Strictures that have narrow or tortuous lumens can be particularly difficult to stent as the luminal diameter must allow access of at least a 0.035 inch guide wire. This review covers the indications and outcomes of different stents in clinical situations to help rational decision-making.
食管支架置入术目前是治疗食管良恶性狭窄的标准方法。目前市场上有多种食管支架可供选择，其支架材料、尺寸和设计各有不同。大多数食管支架由金属合金化合物制成，用于恶性狭窄，不过也有由耐用聚合物制成的支架，现在还有可生物降解（BD）材料制成的支架，可用于良性和恶性狭窄。随着自膨式塑料支架、自膨式金属支架和BD支架的发展，食管病变的支架置入可以安全且具有成本效益。对于治疗内镜医师来说，食管支架置入术存在几个挑战，这取决于狭窄或肿瘤的位置、狭窄的解剖结构以及所选支架的性质。管腔狭窄或迂曲的狭窄病变尤其难以置入支架，因为管腔直径必须允许至少一根0.035英寸的导丝通过。本综述涵盖了不同支架在临床情况下的适应证和结果，以帮助进行合理决策。
