伸展型食管支架治疗食管良恶性狭窄

Clinical Evaluation of Expandable Metallic Esophageal Stent in Treatment of Benign or Malignant Esophageal Stenosis

报告两种伸展型支架治疗食管、贲门良恶性狭窄１２２例次结果。其中包括食管、贲门术后吻合口狭窄、晚期食管癌贲门癌、食管癌放疗后狭窄、食管化学烧伤后狭窄、食管癌性食管气管瘘和贲门失弛症者，效果良好。置管术可在内镜、Ｘ线下或剖胸探查术中进行，能有效地解除梗阻，提高病人生活质量。结论：伸展型支架较传统置管术操作简单，疗效肯定，并发症少，是食管外科的有效方法之一。

Aim:Malignant and benign stenoses of the esophagus affect patients' quality of life.Recently a variety of stents has been used for the management of such problems.This report reviews the clinical results of newly developed expandable metallic esophageal stent in 117 patients.Clinical material and method:One hundred and seventeen patients with malignant or benign esophageal stenoses underwent placement of expandable metallic stents.The underlying causes included advanced esophageal cancer in 51,anastomotic stenoses after partial esophagectomy in 34,stricture caused by radiotherapy in 15,esophagotracheal fistula resulting from infiltrating esophageal cancer in 1,and benign strictures in 16 including 7 esophageal corrosive injuries and 9 achalasias.There were 82 males and 35 females with a mean age of 57.5 years.The diagnoses were made by barium esophagogram and endoscopy.The diameter of esophageal lumen was less than 3mm in 30 cases and between 3mm to 5mm in 87.The length of stricture ranged from 20mm to 120mm.The stent was placed in the stenotic segment under the fluoroscopic and endoscopic guidance.Overall 120 stents were implanted in 117 patients.Results:There was no operative death or postoperative complication.The diameter of esophageal lumen reached 12mm to 16mm after stent placement.Stenting immediately relieved dysphagia in all patients.The mechanical properties of the new prosthesis were excellent.During followup,30 patients with advanced esophageal cancer lived 2.5 to 14 months after stenting(mean,6.7 months).Conclusion:The new expandable metallic esophageal stent is effective in treating malignant and benign esophageal stenoses.It can quickly relieve patients' symptoms and improve their quality of life.