Neuhaus H, Schumacher B
Evangelisches Krankenhaus Düsseldorf.
Z Gastroenterol. 1998 Feb;36(2):121-34.
A variety of metal stents have been increasingly used for malignant esophageal, biliary and colorectal stenoses. Esophageal self-expandable stents significantly reduce the early morbidity after implantation compared to conventional plastic prostheses. However they offer no benefit in the long-term due to various late complications. Biliary stents offer a significantly longer patency than plastic devices. This advantage is however clinically relevant only for patients with a survival time of more than three months. Preliminary trials indicate promising results for palliation of colorectal stenoses with metal stents in selected cases. Due to a lack of comparative studies the different types of metal stents must be selected on basis of their physical characteristics and clinical experiences. Most of the prostheses are irremovable which is a limitation for use in benign stenoses of the gastrointestinal and biliary tract. In addition metal stents are extremely expensive so that carefully designed trials are warranted for evaluation of the cost-benefit ratio.
多种金属支架已越来越多地用于治疗恶性食管、胆管和结肠狭窄。与传统塑料假体相比，食管自膨式支架显著降低了植入后的早期发病率。然而，由于各种晚期并发症，它们在长期内并无益处。胆管支架的通畅时间明显长于塑料装置。然而，这一优势仅在生存期超过三个月的患者中具有临床相关性。初步试验表明，在某些情况下，金属支架缓解结肠狭窄有良好前景。由于缺乏比较研究，必须根据不同类型金属支架的物理特性和临床经验来进行选择。大多数假体不可移除，这限制了其在胃肠道和胆道良性狭窄中的应用。此外，金属支架极其昂贵，因此需要精心设计试验来评估成本效益比。
