Laasch H U, Nicholson D A, Kay C L, Attwood S, Bancewicz J
Department of Diagnostic Radiology, Hope Hospital, Salford, UK.
Clin Radiol. 1998 Sep;53(9):666-72. doi: 10.1016/s0009-9260(98)80293-6.
Between January 1994 and December 1996 72 patients were treated with 76 Gianturco oesophageal stents for oesophageal obstruction or perforation. The patients were followed prospectively in order to determine the effectiveness in improving dysphagia, to establish long term patency, survival times and complications. The mean dysphagia score prior to stenting was 3, improving to a mean score of 1 after stenting. Swallowing failed to improve in three patients. No serious complications were seen at stent insertion. Patients tolerated the procedure well with no complications in 63%. The most frequent immediate complication was chest pain occurring in 15 patients (21%). This settled in all patients with appropriate analgesia, however, four patients required long-term pain relief. In no cases was the chest pain due to perforation. Re-intervention was required in 16.7% of patients, the commonest cause being tumour overgrowth, and this was seen primarily in patients with long survival. The migration rate was low, despite the fact that 45 of 76 stents had been placed with the distal end in the stomach. Only four stents (5.6%) migrated completely, all of which had been deployed across the cardia. In our series the use of the Gianturco oesophageal stents for provided effective palliation of malignant oesophageal obstruction.
1994年1月至1996年12月期间，72例患者接受了76枚Gianturco食管支架治疗食管梗阻或穿孔。对这些患者进行前瞻性随访，以确定改善吞咽困难的有效性、建立长期通畅性、生存时间和并发症情况。置入支架前吞咽困难平均评分为3分，置入后平均改善至1分。3例患者吞咽功能未改善。置入支架时未出现严重并发症。63%的患者对该操作耐受良好，无并发症。最常见的即刻并发症是胸痛，15例患者（21%）出现胸痛。然而，所有患者经适当镇痛后症状均缓解，不过有4例患者需要长期止痛。胸痛均非由穿孔引起。16.7%的患者需要再次干预，最常见的原因是肿瘤过度生长，主要见于生存期长的患者。尽管76枚支架中有45枚远端置于胃内，但移位率较低。只有4枚支架（5.6%）完全移位，所有这些支架均置于贲门处。在我们的系列研究中，使用Gianturco食管支架可有效缓解恶性食管梗阻。
