Govil A, Kumar N
Department of Gastroenterology, G. B. Pant Hospital, New Delhi.
Trop Gastroenterol. 1995 Jan-Mar;16(1):49-58.
Esophageal intubation with a plastic prosthesis is a well established palliative treatment for esophageal carcinoma. The technique is safer with endoscopy than previous surgical techniques. Advantages of stent include rapid and long lasting relief of dysphagia in most patients with carcinoma esophagus. Repeated procedures are not required. Placement of prosthesis is the treatment of choice in BEF. Cost is less compared to other palliative modalities such as laser. SEMS have distinct advantages over conventional prosthesis as they may be inserted with less trauma and fewer complications. Diet needs occasionally to be limited to soft or blenderized foods to prevent occlusion. A disadvantage of uncovered SEMS is short duration of palliation due to tumor ingrowth which can be overcome with availability of covered SEMS. Starvation is the most common cause of death in patients with esophageal malignancy. Prosthesis combats deterioration and leads to rapid weight gain. Overall, single time procedure without general anaesthesia, short hospital stay and immediate improvement in dysphagia are considerable gains.
使用塑料假体进行食管插管是一种成熟的食管癌姑息治疗方法。与以往的手术技术相比，在内镜下该技术更安全。支架的优点包括能迅速且持久地缓解大多数食管癌患者的吞咽困难。无需重复操作。在良性食管狭窄（BEF）中，放置假体是首选治疗方法。与激光等其他姑息治疗方式相比，成本更低。自膨式金属支架（SEMS）比传统假体具有明显优势，因为其插入时创伤较小且并发症较少。有时需要将饮食限制为软食或搅拌食物以防止堵塞。无覆膜SEMS的一个缺点是由于肿瘤长入导致姑息治疗时间短，而有覆膜SEMS则可克服这一问题。饥饿是食管恶性肿瘤患者最常见的死亡原因。假体可对抗病情恶化并使体重迅速增加。总体而言，单次操作无需全身麻醉、住院时间短且吞咽困难立即改善是相当大的收获。
