Scheider D M, Siemens M, Cirocco M, Haber G B, Kandel G, Kortan P, Marcon N E
Center for Therapeutic Endoscopy and Endoscopic Oncology, Wellesley Hospital, Toronto, Canada.
Endoscopy. 1997 May;29(4):271-4. doi: 10.1055/s-2007-1004188.
Tumor ingrowth through self-expanding metal stents presents a difficult problem for management. The techniques for treating tumor ingrowth have not yet been well described, and the optimal endoscopic approach is not clear. We have recently used photodynamic therapy (PDT) to treat tumor ingrowth through uncovered nitinol mesh stents.
Four patients (mean age 73) with obstructive adenocarcinomas of the distal esophagus had received self-expanding stents for palliation of their dysphagia. After stent placement, tumor ingrowth had caused progressive dysphagia in all of the patients; the dysphagia was graded on a scale from 0 (normal) to 4 (inability to swallow liquids). All of the patients received PDT treatment.
After PDT, excellent palliation of the dysphagia was seen in all of the patients, with a mean improvement in the dysphagia score of 2.25 and a mean dysphagia-free interval of 92 days. There were no major complications.
The use of PDT to treat tumor ingrowth through self-expanding metal esophageal stents is effective and safe.
肿瘤长入自膨式金属支架是一个难以处理的问题。治疗肿瘤长入的技术尚未得到充分描述，最佳的内镜治疗方法也不明确。我们最近使用光动力疗法（PDT）治疗肿瘤通过未覆盖的镍钛合金网状支架长入的情况。
4例（平均年龄73岁）远端食管梗阻性腺癌患者因吞咽困难接受了自膨式支架置入术以缓解症状。支架置入后，所有患者均因肿瘤长入导致进行性吞咽困难；吞咽困难程度按0（正常）至4（无法吞咽液体）分级。所有患者均接受了PDT治疗。
PDT治疗后，所有患者的吞咽困难均得到显著缓解，吞咽困难评分平均改善2.25分，平均无吞咽困难间隔时间为92天。无严重并发症发生。
使用PDT治疗肿瘤通过自膨式金属食管支架长入是有效且安全的。
