Vargas-Tank L, Ovalle L, Fernández C, Mella B, Estay R, del Solar M P, Soto J R
Departamento de Gastroenterología, Servicio de Medicina y Servicio de Radiología, Hospital San Juan de Dios, Universidad de Chile.
Gastrointest Endosc. 1995 Jan;41(1):8-10. doi: 10.1016/s0016-5107(95)70268-7.
Risk of perforation is a major impediment to the use of polyvinyl bougies in palliative dilation of cancerous strictures of the esophagus. We encountered 23 patients with complex malignant strictures in whom initial dilation with Savary-Gilliard bougies was thwarted because attempts to pass a conventional Eder-Puestow guide wire were unsuccessful. As a recourse, we probed these strictures with a very flexible guide wire of the type used to implant prostheses in the biliary tract. The purpose was to establish a passage through which a standard guide wire could then be inserted. The procedure was successful in all but 4 of the 23 patients. We conclude that in such cases the preliminary use of the very flexible guide, even though time-consuming, improves the chance of effective dilation with minimal added risk.
穿孔风险是在食管癌性狭窄姑息性扩张中使用聚乙烯探条的主要障碍。我们遇到23例复杂恶性狭窄患者，最初使用Savary-Gilliard探条进行扩张时受阻，因为尝试通过传统的Eder-Puestow导丝未成功。作为一种补救措施，我们用一种非常柔软的、用于在胆道植入假体的导丝探测这些狭窄部位。目的是建立一个通道，以便随后能够插入标准导丝。在这23例患者中，除4例之外，该操作在其余患者中均成功。我们得出结论，在这种情况下，即使耗时，预先使用非常柔软的导丝也能提高有效扩张的机会，且增加的风险最小。
