Kato M, Saji S, Kanematsu M, Hoshi H, Ishiguchi T, Kunieda K, Takao H, Sugiyama Y
Second Department of Surgery, Gifu University School of Medicine.
Jpn J Clin Oncol. 1996 Dec;26(6):461-4. doi: 10.1093/oxfordjournals.jjco.a023264.
To evaluate the utility and limitations of palliative stenting with polyurethane-covered self-expandable metallic stents, 6 patients (3 males and 3 females ranging in age from 58-85 [mean 72.1] years) with malignant esophageal strictures were treated with these stents between April 1993 and October 1995. Three had esophageal carcinoma, two had gastric carcinoma and one had lung carcinoma. Song-type self-expandable metallic stents were inserted by intubation under local laryngeal anesthesia. A retriever was attached in 4 stents and an anti-reflux mechanism was attached in 2 stents placed over the esophagocardiac strictures. The stents were placed successfully in all patients, and no major complication related to intubation was encountered. All the stents fully expanded within 3 days after insertion. The grade of dysphagia was improved in 5 (83%) of the 6 patients. One stent was extracted using a retriever in one patient with no improvement. No reflux symptoms were observed in 2 patients whom received stents with an anti-reflux mechanism. No blockage of the stent due to food impaction or secondary stricture occurred in any patient during the observation period. One stent migrated into the stomach in one patient 27 days after insertion. Esophageal stenting with polyurethane-covered self-expandable metallic stents is a relatively safe and effective palliation for malignant esophageal strictures.
为评估聚氨酯涂层自膨式金属支架姑息性置入术的效用及局限性，于1993年4月至1995年10月期间，对6例（3例男性，3例女性，年龄58 - 85岁[平均72.1岁]）恶性食管狭窄患者采用这些支架进行治疗。其中3例为食管癌，2例为胃癌，1例为肺癌。在局部喉麻醉下经插管置入Song型自膨式金属支架。4枚支架附带有回收装置，2枚放置于食管贲门狭窄处的支架附带有抗反流装置。所有患者支架均成功置入，未出现与插管相关的严重并发症。所有支架在置入后3天内完全展开。6例患者中有5例（83%）吞咽困难程度得到改善。1例患者支架置入后无改善，使用回收装置取出1枚支架。2例接受带有抗反流装置支架的患者未观察到反流症状。观察期间，所有患者均未出现因食物嵌塞或继发性狭窄导致的支架堵塞。1例患者在支架置入27天后有1枚支架移入胃内。聚氨酯涂层自膨式金属支架置入术是一种治疗恶性食管狭窄相对安全有效的姑息治疗方法。
