Watkinson A F, Ellul J, Entwisle K, Mason R C, Adam A
Department of Radiology, United Medical School, Guy's Hospital, London, England.
Radiology. 1995 Jun;195(3):821-7. doi: 10.1148/radiology.195.3.7538682.
To assess the effectiveness of a polyurethane-covered self-expanding metallic endoprosthesis in the relief of dysphagia due to irresectable esophageal carcinoma.
Thirty-two patients (20 men, 12 women) aged 41-89 years (median, 70 years) with inoperable esophageal carcinoma underwent stent placement (44 stents). All patients underwent both clinical and radiologic examination before and after treatment. Clinical follow-up was performed at 4-week intervals.
Stent placement was successful in all patients, with good symptomatic relief and no serious complications. Eleven patients needed more than one stent because of early partial migration, late complete migration, tumor overgrowth, or long stricture. Seven patients had associated esophageal fistulization or perforation; leaks were successfully sealed after stent insertion. The mean dysphagia score was 3.38 +/- 0.49 (standard deviation) before treatment and 0.81 +/- 0.88 at 3-4 days after insertion. Nineteen patients died, with a median survival time of 78 days (range, 12-245 days), and 13 were alive 14-67 days (median, 30 days) after treatment and were swallowing a near normal diet.
The insertion of plastic-covered endoprostheses provides rapid, safe, and effective palliation of malignant esophageal obstruction.
评估聚氨酯覆膜自膨式金属内支架对不可切除食管癌所致吞咽困难的缓解效果。
32例年龄41 - 89岁（中位年龄70岁）的不可手术食管癌患者（男20例，女12例）接受了支架置入（共44枚支架）。所有患者在治疗前后均接受了临床和影像学检查。临床随访每4周进行一次。
所有患者支架置入均成功，症状缓解良好，无严重并发症。11例患者因早期部分移位、晚期完全移位、肿瘤过度生长或长段狭窄需要置入不止一枚支架。7例患者合并食管瘘或穿孔；支架置入后漏口成功封闭。治疗前吞咽困难平均评分为3.38±0.49（标准差），置入后3 - 4天为0.81±0.88。19例患者死亡，中位生存时间为78天（范围12 - 245天），13例患者在治疗后14 - 67天（中位30天）存活，能吞咽接近正常的饮食。
置入覆膜内支架可快速、安全且有效地缓解恶性食管梗阻。
