食管支架治疗恶性食管-气管瘘

Treatment of malignant esophago -tracheal fistula with intraesophageal stent

目的 探讨国产金属被膜内支架经食管置入，治疗食管－气管瘘的疗效。方法９例中，男７例，女２例，年龄４６－７２岁，平均５３．４岁。因放疗引起食管－气管瘘者食管癌３例，肺癌１例；肺癌支气管动脉灌注治疗后２例，手术后复发病人３例。全组病例均有饮水呛咳，吞咽困难，并均经手术或内镜病理证实，造影发现有食管－气管瘘口。病理结果为：小细胞肺癌２例；肺鳞癌 １例；食管鳞癌６例。支架上端呈漏斗状，上下长于病灶２ｃｍ，支架到位后，用直径 １．５ ｃｍ球囊导管扩张，封闭瘘口，固定支架。结果５例可进普食，４例进半流食，１周后改进普食。结论 带膜金属内支架治疗食管－气管瘘安全有效，是首选的治疗方法。

Objective To evaluate the therapeutic effects of intraesophageal metallic stent with a membrane in malignant esophago - tracheal fistula. Methods Nine patients with radiographically shown and surgically or endoscopy proven malignant esophago - tracheal fistula in which 3 cases of esophageal cancer and 2 cases of lung cancer were induced by radiotherapy, 1 case of lung cancer was induced by bronchioarterial infusion treatment and remainder 3 cases were due to postoperative reoccurrence underwent to set stent with 2 cm longer than superior and inferior segment of the lesion into the cancerous stenosed segment of the esophagus. The lesions histopathologically showed that pulmonary small cell cancer was found in 2 cases, pulmonary squamous cell cancer in 1 and esophageal squamous cell cancer in 3. Results After the operation 5 patients could immediately eat some common foods, 4 patients could eat some half- fluid foods and then changed into common foods after one week Conclusion The metallic stent setting into the cancerous stenosed segments of esophagus is a very safe and effective for treating malignant esophago - tracheal fistula and should be taken as a first selective method.