Kooijman W, Taal B G, Boot H
Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis, afd. Gastro-enterologie en Medische Oncologie, Amsterdam.
Ned Tijdschr Geneeskd. 1998 Apr 11;142(15):845-50.
To compare the results of plastic endoprostheses and of self expanding stents in patients with an esophagobronchial fistula.
Retrospective, descriptive.
Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, the Netherlands.
Forty-two patients with an esophagobronchial fistula caused by a malignant tumour in the oesophagus, lungs or mediastinum were fitted with an endoprosthesis during the period 1 January 1991-31 August 1995. Use was made initially of a plastic endoprosthesis with a special tulip funnel (n = 24), later of a coated self expanding stent (n = 18). In seven patients, the fistula had been the first manifestation of the tumour; in 35, a recurrence after earlier treatment was involved. The initial characteristics (sex, age, diagnosis, earlier therapy, signs and symptoms) were the same in both groups.
Dilatation immediately before insertion of a plastic endoprosthesis was necessary in 23 patients (96%); such dilatation was necessary in four of the patients (22%) fitted with a self expanding stent. Complete sealing of the fistula was achieved in 19 (79%) and 15 (83%) patients, respectively. Reoperations were necessary in eight (33%) and three (17%) patients. Early major complications occurred in four (17%) and two (11%) patients.
The selfexpanding stent was faster and easier to insert than a plastic endoprosthesis, and effective in sealing an oesophagobronchial fistula.
比较塑料内置假体和自膨式支架治疗食管支气管瘘患者的效果。
回顾性、描述性研究。
荷兰阿姆斯特丹的荷兰癌症研究所/安东尼·范·列文虎克医院。
1991年1月1日至1995年8月31日期间，42例因食管、肺部或纵隔恶性肿瘤导致食管支气管瘘的患者接受了内置假体治疗。最初使用带有特殊郁金香漏斗的塑料内置假体（n = 24），后来使用涂层自膨式支架（n = 18）。7例患者中，瘘管是肿瘤的首发表现；35例患者是早期治疗后复发。两组患者的初始特征（性别、年龄、诊断、既往治疗、体征和症状）相同。
23例（96%）接受塑料内置假体治疗的患者在插入前需要扩张；接受自膨式支架治疗的4例（22%）患者也需要这种扩张。分别有19例（79%）和15例（83%）患者的瘘管完全闭合。8例（33%）和3例（17%）患者需要再次手术。4例（17%）和2例（11%）患者发生早期严重并发症。
自膨式支架比塑料内置假体插入更快、更容易，且能有效封闭食管支气管瘘。
