Heindorff H, Wøjdemann M, Bisgaard T, Svendsen L B
Dept. of Gastrointestinal Surgery C, Rigshospitalet, University of Copenhagen, Denmark.
Scand J Gastroenterol. 1998 Jan;33(1):21-3. doi: 10.1080/00365529850166158.
Cancer of the oesophagus and the cardia tends to present late. Palliation of dysphagia is the prospect of most of the patients. This paper reports the use of argon electrocoagulation in 83 patients with inoperable cancer strictures in the oesophagus and cardia.
The argon electrocoagulation was done by a fibre conducting electricity and argon air to the site of coagulation. After treatment the patients were allowed to take fluids and normal food the same evening or the next morning. After recanalization the patients were treated regularly every 3-4 weeks.
Recanalization enabling passage for normal food was achieved with 1 treatment in 48 patients (58%), whereas 22 (26%) needed more than 1 treatment. In 13 patients (16%) the ability to eat normal food was not achieved. In these patients dysphagia improved at least one grade. Perforation was seen in seven patients (8%) and in 1% of treatments. Perforations were successfully treated conservatively in six of the seven patients. Sixty-three patients (76%) died during the investigation period, on average 146 days (range, 43-397 days) after diagnosis.
Argon electrocoagulation offers an easy, cheap, and safe alternative to treatment with laser photocoagulation and expandable metal stents.
食管癌和贲门癌往往就诊时已属晚期。缓解吞咽困难是大多数此类患者的期望。本文报告了氩气电凝术在83例无法手术的食管和贲门癌性狭窄患者中的应用。
通过将纤维传导电流和氩气输送至凝血部位来进行氩气电凝术。治疗后，允许患者在当晚或次日早晨进食流食和正常食物。再通后，患者每3 - 4周接受一次常规治疗。
48例患者（58%）经1次治疗后实现再通，能够正常进食；而22例（26%）需要不止1次治疗。13例患者（16%）未能实现正常进食能力，但吞咽困难至少改善了一个等级。7例患者（8%）在治疗中出现穿孔，占治疗总数的1%。7例患者中有6例穿孔经保守治疗成功。63例患者（76%）在研究期间死亡，诊断后平均146天（范围43 - 397天）。
氩气电凝术为激光光凝术和可扩张金属支架治疗提供了一种简便、廉价且安全的替代方法。
