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纤维内镜下食管胃肿瘤的姑息性插管术

Palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy.

作者信息

Ogilvie A L, Dronfield M W, Ferguson R, Atkinson M

出版信息

Gut. 1982 Dec;23(12):1060-7. doi: 10.1136/gut.23.12.1060.

Abstract

Of one hundred and twenty-one patients with neoplastic obstruction of the oesophagus or cardia 118 underwent palliative intubation at fibreoptic endoscopy on a total of 135 occasions. Sixty had adenocarcinoma, 49 had squamous carcinoma, and in nine the oesophagus was involved by a growth arising elsewhere. Satisfactory swallowing ws restored in 112 patients. Thirteen patients died in hospital shortly after the procedure. Five fatal and 10 non-fatal perforations were sustained in 135 intubation procedures. Complications of tube function included food blockage on 26 occasions, tumour overgrowth on seven occasions, displacement on 16 occasions, disappearance of the tube in two patients, and late oesophageal perforation on nine occasions. Fifty-six patients survived for three months, 33 for six months, and 10 for a year after intubation. Comparison with series in the literature of patients who underwent surgical palliative intubation suggests that endoscopic palliation has lower mortality and morbidity, and an increased survival time, and is now the method of choice for palliation of oesophagogastric neoplasms.

摘要

在121例患有食管或贲门肿瘤性梗阻的患者中,118例在纤维内镜检查时接受了姑息性插管,共进行了135次。其中60例为腺癌,49例为鳞癌,9例食管受其他部位肿瘤侵犯。112例患者吞咽功能恢复良好。13例患者在术后不久死于医院。135次插管操作中有5例致命穿孔和10例非致命穿孔。管道功能并发症包括食物堵塞26次、肿瘤过度生长7次、移位16次、2例患者管道消失以及晚期食管穿孔9次。56例患者插管后存活3个月,33例存活6个月,10例存活1年。与接受手术姑息性插管患者的文献系列比较表明,内镜姑息治疗死亡率和发病率较低,生存时间延长,目前是食管胃肿瘤姑息治疗的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f03/1419858/08ab897fe21e/gut00421-0065-a.jpg

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