自膨式金属支架在胃肠道各段恶性狭窄治疗中的作用
The Role of Self-Expandable Metallic Stents in the Treatment of Malignant Strictures in all Segments of the Gastrointestinal Tract.
作者信息
Çağatay A K, Sayar Süleyman, Kılıç Ebru Tarıkçı, Kahraman Resul, Öztürk Oğuzhan, Özdil Kamil
机构信息
Department of Gastroenterology, Health Sciences University Umraniye Training and Research Hospital, Istanbul, Turkey.
Department of Anestesiology, Health Sciences University Umraniye Training and Research Hospital, Istanbul, Turkey.
出版信息
Indian J Palliat Care. 2023 Jan-Mar;29(1):64-69. doi: 10.25259/IJPC_106_2021. Epub 2023 Jan 11.
OBJECTIVES
Management of malignant gastrointestinal (GI) obstruction presents a significant challenge. Most patients are in a profoundly decompensated state due to underlying malignancy and are not ideal candidates for invasive surgical procedures. Self-expandable metallic stents (SEMSs) are used to provide permanent or temporary patency in all endoscopically accessible stenosis of the GI tract. In this study, it is aimed to analyse the characteristics and the efficacy of patients with malignant stenosis treated with SEMS, in all segments of the GI tract.
MATERIAL AND METHODS
The sample consisted of 60 patients who underwent SEMS replacement, between 10 March 2014 and 16 December 2020, to treat malignant-related strictures in the GI tract at the Gastroenterology Department of the Health Sciences University Umraniye Training and Research Hospital. The data of the patients, hospital data processing database and electronic endoscopic database records were retrospectively scanned and recorded. The general characteristics of the patients and the treatment-related features were analysed.
RESULTS
The mean age of patients who were placed SEMS was 69.7 ± 13.7 years. Uncovered (15%, : 9), fully covered (13.3%, : 8), or partially covered (71.6%, : 43) SEMS were successfully placed in all patients. Clinical success in patients with SEMS was 85.7% in the esophagus, 100% in the small intestine and 90.9% in the stomach and colon. About 11.4% migration, 14.2% pain, 11.4% overgrowth and 5.7% ingrowth were detected in patients who had SEMS placed in the oesophagus. Pain was detected in 9.1% and ingrowth in 18.2% of patients who had SEMS placed in the stomach. Pain was detected in 18.2% of the patients who had SEMS placed in the colon and migration was found in 9.1%.
CONCLUSION
SEMS implant is a minimally invasive effective method in the palliative treatment of malignant strictures of the GI tract.
目的
恶性胃肠道梗阻的管理是一项重大挑战。大多数患者由于潜在的恶性肿瘤而处于严重失代偿状态，并非侵入性外科手术的理想候选人。自膨式金属支架（SEMS）用于在胃肠道所有内镜可及的狭窄部位提供永久性或临时性通畅。本研究旨在分析接受SEMS治疗的胃肠道各段恶性狭窄患者的特征及疗效。
材料与方法
样本包括2014年3月10日至2020年12月16日期间在健康科学大学乌姆拉尼耶培训与研究医院胃肠病科接受SEMS置换以治疗胃肠道恶性相关狭窄的60例患者。对患者数据、医院数据处理数据库和电子内镜数据库记录进行回顾性扫描和记录。分析患者的一般特征和治疗相关特征。
结果
接受SEMS置入的患者平均年龄为69.7±13.7岁。所有患者均成功置入裸支架（15%，9例）、全覆膜支架（13.3%，8例）或部分覆膜支架（71.6%，43例）。SEMS置入患者的临床成功率在食管为85.7%，小肠为100%，胃和结肠为90.9%。食管置入SEMS的患者中检测到约11.4%的支架移位、14.2%的疼痛、11.4%的过度生长和5.7%的向内生长。胃置入SEMS的患者中9.1%检测到疼痛，18.2%检测到向内生长。结肠置入SEMS的患者中18.2%检测到疼痛，9.1%发现支架移位。
结论
SEMS植入是胃肠道恶性狭窄姑息治疗中的一种微创有效方法。
Zotero 插件