Haringsma J, Ferwerda J, Dekker W, Brom H L
Dept. of Internal Medicine, Kennemer Gasthuis, Haarlem, The Netherlands.
Endoscopy. 1997 Mar;29(3):188-91. doi: 10.1055/s-2007-1004161.
Different types of expandable metal stent are currently available for the palliative treatment of malignant esophageal strictures. To overcome some of the disadvantages involved in the design of metal mesh stents, we designed a balloon-expanded plastic endoprosthesis, which is hardened by irradiation with ultraviolet light after deployment. We present here our preliminary results.
From April 1995 to January 1996, four patients with unresectable esophageal malignancies were treated with this stent. Insertion of the stent was the only palliative procedure carried out. The patients were followed up until death.
Stent placement was successful in all patients, and no procedure-related complications occurred. Dysphagia was reduced from an average score of 2.6 to 1.0. Early complications included retrosternal pain of limited duration in one patient. One patient died 72 hours after uncomplicated stent placement, due to cardiac arrhythmia. Late complications were limited to tumor overgrowth in two patients, after a mean of 104 days. The stent patency rate averaged 92 days.
In patients with a malignant esophageal stricture, this newly developed expandable endoprosthesis is effective in relieving dysphagia. The deployment of the stent is easy and safe. The endoprosthesis has potential advantage over current expandable metal mesh stents.
目前有不同类型的可扩张金属支架用于恶性食管狭窄的姑息治疗。为克服金属网状支架设计中存在的一些缺点,我们设计了一种球囊扩张式塑料内支架,其在置入后通过紫外线照射硬化。在此我们展示初步结果。
1995年4月至1996年1月,4例无法切除的食管恶性肿瘤患者接受了该支架治疗。支架置入是唯一实施的姑息治疗手段。对患者进行随访直至死亡。
所有患者支架置入均成功,且未发生与操作相关的并发症。吞咽困难评分从平均2.6分降至1.0分。早期并发症包括1例患者出现持续时间有限的胸骨后疼痛。1例患者在支架置入无并发症后72小时因心律失常死亡。晚期并发症仅限于2例患者出现肿瘤过度生长,平均发生时间为104天。支架通畅率平均为92天。
对于恶性食管狭窄患者,这种新开发的可扩张内支架在缓解吞咽困难方面有效。支架置入操作简便且安全。该内支架相对于目前的可扩张金属网状支架具有潜在优势。