食管支架置入术后再狭窄的内镜治疗

Endoscopic treatment for restenosis of esophagus after stenting

目的探讨食管支架置入术后再狭窄的原因及治疗方法。方法对2003年6月～2005年6月15例经内镜治疗的食管支架置入术后再狭窄患者的临床资料进行回顾性分析。结果食管支架置入术后再狭窄发生率为17.2%(15/87),其中食物嵌顿1例,支架远端移位2例,肉芽组织形成及纤维化(granulationandfibrosis,GF)6例,肿瘤组织过生长新生物(tumour-overgrowing,TG)6例。1例食物嵌顿者以内镜取出食物后缓解,2例GF一直接受氩等离子体凝固器(argonplasmacoagulation,APC)治疗,其余12例均再次放置支架而解除了狭窄。结论食管支架置入术后再狭窄的原因是多种的,针对不同的原因可以采取不同的有效预防和治疗措施。

[Objective] To investigate the reasons and methods of endoscopic treatment for restenosis of esophagus after stent implantation. [Methods] The clinical data of 15 patients with restenosis of esophagus after stent implantation treated with endoscopy from June 2003 to June 2005 were analysed retrospectively. [Results] The total rate of recurrent obstructions of esophagus after stent implantation was 17.2% （15/87）. Of 15 patients, one patient was caused by food impaction, 2 were distal stent migration, 6 were granulation and fibrosis （GF）, 6 were tumourovergrowing （TG）. One patient＇s lumpish food occluded in stent was removed through endoscopy; 2 patients with GF were treated by APC at all times, 12 patients were solved by renewed stent implantation. [Conclusion] There are various causes which can lead to the restenosis of esophagus after stent implantation. The active prophylactic and therapeutic procedures are of great help for reducing restenosis and improving therapeutic results.