Carreira Villamor J M, Reyes Pérez R, Górriz Gómez E, Pulido-Duque J M, Argilés Vives J M, Pardo Moreno M D, Maynar Moliner M
Unidad de Radiología Vascular Intervencionista, Hospital Ntra. Sra. del Pino, Las Palmas, España.
Nutr Hosp. 1997 May-Jun;12(3):141-6.
The objective of this study was to present our experience with metallic stents (Wallstent) for palliation of dysphagia due to malignant esophageal obstruction and esophagotracheal fistula.
From August 1994 to July 1996 20 uncovered and 6 covered stents were inserted in 16 consecutive patients with dysphagia grade 3 (n = 4) or grade 4 (n = 12) caused by incurable malignant obstructions. The obstruction was in the proximal (n = 4), in the middle (n = 3) and the distal (n = 9) third of the esophagus. Five patients presented with esophagotracheal fistula. The stent insertion was performed under fluoroscopic control.
Exact positioning of the stent with reduction of the dysphagia was obtained in all patients. There were no complications related with the procedure. Esophagotracheal fistula was solved in those patients treated with covered stents. Six patients had recurrent dysphagia due to tumor ingrowth or overgrowth. In these patients an additional overlapping stent was placed. In latest evaluation 2 patients presented dysphagia grade I, 5 grade III, and 4 grade IV.
Implantation of stents proved to be an effective and safe method of palliating dysphagia and occluding esofagotracheal fistula. Placement of stents was feasible without major procedure-related complications.
本研究的目的是介绍我们使用金属支架（Wallstent）缓解恶性食管梗阻和食管气管瘘所致吞咽困难的经验。
1994年8月至1996年7月，对16例因无法治愈的恶性梗阻导致吞咽困难3级（n = 4）或4级（n = 12）的连续患者植入了20个裸支架和6个覆膜支架。梗阻位于食管上段（n = 4）、中段（n = 3）和下段（n = 9）。5例患者伴有食管气管瘘。支架置入在荧光透视控制下进行。
所有患者支架定位准确，吞咽困难减轻。未发生与手术相关的并发症。覆膜支架治疗的患者食管气管瘘得到解决。6例患者因肿瘤长入或过度生长出现复发性吞咽困难。对这些患者额外放置了一个重叠支架。在最近一次评估中，2例患者为I级吞咽困难，5例为III级，4例为IV级。
支架植入被证明是缓解吞咽困难和封堵食管气管瘘的一种有效且安全的方法。支架置入可行，未出现重大手术相关并发症。
