Inoue Teruaki
Department of Internal Medicine, Fujinomiya City General Hospital, Fujinomiya-shi, Japan.
Oxf Med Case Reports. 2022 Oct 22;2022(10):omac103. doi: 10.1093/omcr/omac103. eCollection 2022 Oct.
Self-expandable metal stents (SEMS) have often been used to treat malignant colorectal obstruction. But SEMS obstruction occurs due to the ingrowth of colorectal cancer. We report a case in which treatment with argon plasma coagulation (APC) was effective for SEMS obstruction. An 89-year-old man was admitted to our hospital for obstructive colorectal cancer. A SEMS was inserted and it improved malignant colorectal obstruction. Computed tomography scans demonstrated liver and lung metastases. His clinical cancer staging was IVb and he wished to receive palliative care. Two months later, SEMS obstruction occurred due to ingrowth of colorectal cancer. Treatment other than stent-in-stent SEMS insertion was considered because SEMS obstruction occurred in a short period of time. APC treatment was chosen and it improved the obstruction. The duration of stent patency was 62 days. APC is an option but it needs further studies to assess the safety of APC.
自膨式金属支架（SEMS）常用于治疗恶性大肠梗阻。但SEMS梗阻是由结直肠癌向内生长引起的。我们报告一例氩等离子体凝固（APC）治疗SEMS梗阻有效的病例。一名89岁男性因梗阻性结直肠癌入住我院。插入了一个SEMS，它改善了恶性大肠梗阻。计算机断层扫描显示有肝和肺转移。他的临床癌症分期为IVb期，他希望接受姑息治疗。两个月后，由于结直肠癌向内生长，发生了SEMS梗阻。由于SEMS梗阻在短时间内发生，考虑采用除支架内再置入SEMS之外的其他治疗方法。选择了APC治疗，梗阻得到改善。支架通畅持续时间为62天。APC是一种选择，但需要进一步研究以评估APC的安全性。
