Nicholson D A
Department of Radiology, Hope Hospital, Salford, UK.
Clin Radiol. 1998 Oct;53(10):760-3. doi: 10.1016/s0009-9260(98)80320-6.
Two cases of combined tracheal and oesophageal stenting for carcinoma of the upper oesophagus invading the tracheo-bronchial tree are described. Case 1 describes the complication of respiratory distress following insertion of a high oesophageal stent. This caused severe stridor which required tracheal stenting. In case 2 prophylactic stenting of the airway prior to oesophageal stenting was performed as a staging CT demonstrated severe compromise of the distal trachea/bronchus in a patient who was experiencing both dysphagia and dyspnoea. In both cases the respiratory and dyspnoeic symptoms were relieved. These cases illustrate the effective use of tracheal/bronchial and oesophageal metal stents in palliating patients with combined respiratory and dysphagic symptoms secondary to oesophageal malignancy. When treating high oesophageal tumours tracheal compromise should be considered and prophylactic stenting of the airway prior to oesophageal stenting performed to avoid further airway compromise when the oesophageal stent expands.
本文描述了两例因上段食管癌侵犯气管支气管树而进行气管和食管联合支架置入的病例。病例1描述了高位食管支架置入后出现呼吸窘迫并发症。这导致了严重的喘鸣，需要进行气管支架置入。病例2中，由于分期CT显示一名同时患有吞咽困难和呼吸困难的患者远端气管/支气管严重受压，在食管支架置入前对气道进行了预防性支架置入。在这两个病例中，呼吸和呼吸困难症状均得到缓解。这些病例说明了气管/支气管和食管金属支架在缓解因食管恶性肿瘤继发的呼吸和吞咽困难症状患者中的有效应用。在治疗高位食管肿瘤时，应考虑气管受压情况，并在食管支架置入前对气道进行预防性支架置入，以避免食管支架扩张时进一步压迫气道。
