Cozzi G, Colnago M F, Bellomi M, Giovannardi G, Salvetti M, Severini A
Divisione di Radiodiagnostica C, Istituto Nazionale per lo Studio e la Cura dei Tumori di Milano.
Radiol Med. 1994 Sep;88(3):272-6.
Self-expanding metal stents have been recently used for the treatment of neoplastic esophageal stenoses. In our series, nitinol Strecker stents were implanted in ten patients with malignant esophageal intrinsic or extrinsic strictures, as a definitive palliation. Thirteen stents in all were used: two stents were positioned in three patients to recanalize the esophagus. The prostheses could always be inserted in the treated patients and in all of them swallowing was markedly improved. No major early complications were observed after stent insertion. All the stents but one were patent until the patient's death. Two patients are alive and bearing well-functioning stents. Self-expanding metal stents are to be preferred to plastic endoscopic tubes because their caliber is smaller at the time of insertion and they do not require general anesthesia, as endoscopic tubes sometimes require. Moreover, their complication rate is lower for both early and late complications. Tumor ingrowth through the stent mesh with stent occlusion is the major pitfall of these prostheses, together with the impossibility to use them when esophageal fistulas are present: these limitations will be soon overcome when silicone-coated expandable stents are on the market.
自膨式金属支架最近已用于治疗肿瘤性食管狭窄。在我们的系列研究中，镍钛诺施特雷克支架被植入10例患有恶性食管内在或外在狭窄的患者体内，作为一种确定性姑息治疗。总共使用了13个支架：3例患者中放置了2个支架以重新打通食管。假体总能成功插入接受治疗的患者体内，并且所有患者的吞咽功能均有显著改善。支架置入后未观察到严重的早期并发症。除1个支架外，所有支架直至患者死亡时均保持通畅。2例患者存活且支架功能良好。自膨式金属支架比塑料内镜管更具优势，因为其插入时管径较小，且有时不像内镜管那样需要全身麻醉。此外，其早期和晚期并发症的发生率均较低。肿瘤通过支架网眼向内生长并导致支架堵塞是这些假体的主要缺陷，同时存在食管瘘时无法使用：当硅胶涂层可膨胀支架上市后，这些局限性将很快被克服。
