食管胃吻合口良性狭窄的内镜治疗

Treatment of Benign Esophageal Stricture after Surgery under Endoscope

【目的】探讨食管胃吻合口良性狭窄的两种内镜治疗的效果与经验。【方法】将48例食管癌术后吻合口良性狭窄的患者分别进行内镜下治疗,其中有22例单纯予以球囊扩张术,8例经球囊扩张术后放置食管镍钛记忆金属支架,18例经球囊扩张术后放置全覆膜可取出金属支架(Sigma支架),评价近期及远期疗效。【结果】单纯球囊扩张术治疗的22例中,吞咽困难改善总有效率为90.9%,其中9例发生再狭窄;8例经球囊扩张术后放置食管镍钛记忆金属支架,其中2例再次出现狭窄;18例经球囊扩张术后放置Sigma支架,无1例出现再狭窄。【结论】全覆膜可取出金属支架是治疗食管胃吻合口术后良性狭窄的较佳方案。

[Objective]To investigate the therapeutic effect and experience of two methods on benign e- sophageal stricture after surgery under endoscope. [Methods]Forty eight cases of esophageal stricture after surgery of esophageal cancer were treated under endoscope. Twenty two cases of them were treated only by balloon dilatation, 8 cases were treated by balloon dilatation followed by placing Ni-Ti memorable metallic stent, and the other 18 were treated by balloon dilatation followed by placing covered retrievable metallic stent （Sigma stent）. And the short-and long-term efficacy was evaluated. [Results]Among 22 cases treated only by balloon dilatation, the total effective rate of improvement of symptoms of dysphagia was 90. 9%, and 9 of them occurred esophageal stricture again. Among 8 cases treated by balloon dilatation followed by placing Ni-Ti memorable metallic stent, 2 of them occurred stricture again. No one relapsed in the 18 cases treated by balloon dilatation followed by placing Sigma stent. [Conclusion]Placing covered retrievable metallic stent is a better way to treat esophageal stricture after surgery and can approach a high therapeutic rate.