食管癌治疗后带膜食管支架应用的中远期疗效评价

The medium and long-term therapeutic effect: clinical application of covered stent after operation or radiotherapy for esophageal cancer

目的：评价食管癌手术或放射治疗后带膜食管支架应用的中远期疗效.方法：36例食管癌手术或放射治疗后出现食管或吻合口狭窄、食管-气管或纵隔瘘的患者行带膜食管支架置入术,并进行21～86个月的随访.所有病例均行食管点片,复发性食管狭窄患者行内窥镜检查随访.结果：所有病例支架置入均获成功.21例患者随访中死亡,支架置入后生存期是1月～53个月.其中10例死于肿瘤复发,2例死于肿瘤广泛转移,3例死于食管大出血,2例死于肺部炎症,4例死于不明原因.随访中仍然健在15例,生存时间为支架置入术后21个月～74个月.结论：带膜食管支架在食管癌治疗后的应用近期疗效满意,而中长期疗效较差,多种并发症所导致的患者的最终死亡是食管支架治疗应用的不足.

Objective： To evaluate the medium and long-term therapeutic effect in covered stent for esophageal cancer after operation or radiotherapy.Methods：36 cases with esophageal stenosis or esophagus-trachea fistula were followed up for 21 - 86 months after inserting covered stent. There were 28 men and 8 women, aged from 40 to 84 years （mean 57.2 years）. Follow-up esophagngrams were obtained in all patients. Endoscopy was porformed on recurrent stenosis. Results：Stents were inserted successful in all patients. The mean survival time was 13.5 months （1 to 53 months） in 21 cases. There were 10 cases with tumor recurrent, 2 cases metastuses, 3 cases bleeding, 2 cases pneumonia, 4 cases died from complications or other reasons. There are 15 survivors, survival period was from 21 to 74 months. Conclusion：The covered stent has less medium therapeutic effect duing recently and worse durng long-term on the patients with esophageal cancer after operation or radiotherapy.