带膜金属支架治疗食管癌术后胸内吻合口瘘的临床研究

Research of Application of Metallic Stent with Membrane for Treatment of Intrathoracic Anastomotic Fistula after Esophagectomy

目的探讨镍钛记忆合金带膜内支架在治疗食管癌术后胸内吻合口瘘中的应用价值。方法在X线电视透视下对22例食管癌术后胸内吻合口瘘患者进行镍钛记忆合金带膜内支架植入治疗。结果19例一次植入成功,成功率86%,恢复正常饮食;不完全封堵瘘口3例(14%);16例术后出现轻度的胸骨后疼痛不适或胃液反流的症状;1例出现上消化道大出血。22例病人均治愈出院,治愈率100%。结论镍钛记忆合金带膜内支架植入治疗食管癌术后胸内吻合口瘘成功率高,治愈率高,操作简单,安全,见效快,并发症少,有效解除患者痛苦,宜在临床上推广使用。

Objective To investigate the value of metallic stent with membrane for the treatment of intrathoracic anastomotic fistula after esophagectomy. Methods Place the metallic stent with membrane in 22 patients with intrathoracic anastomotic fistula after esophagectomy under X-ray machine. Results Stents were successfully placed in 19 patients for the first time （86%）. The patients returned to normal diets. Orificinm fistulae were incompletely covered in 3 patients （14%）. 16 patients had slight retrostemal pain and symptoms of reflowing. 1 patient had massive hemorrhage of gastrointestinal tract. All the patients discharged with cured anastomotic fistula. Conclusion Application of metallic stent with membrane for treatment of intrathoracic anastomotic fistula after esophagectomy has high achievement rate and recovery rate. The operation was simple, safe, with excellent effect and less complications. It could effectively release the passion of patients. It＇s reasonable to extend the application of the stent.