内镜直视下带膜支架置入联合氩气刀治疗晚期食管癌

Therapy of membrane covered self-expanding metallic stent combined with argon plasma coagulation for advanced esophageal carcinoma under endoscope

目的探索内镜直视下应用带膜记忆合金支架联合氩气刀对晚期食管癌的治疗方法。方法回顾分析6例内镜直视下应用带膜记忆合金支架联合氩气刀治疗晚期食管癌患者的临床资料。结果63例患者中,上段2例,置放成功2例,成功率100%;中段49例,置放成功49例,成功率100%;下段12例,置放成功12例,成功率100%。结论内镜直视下应用带膜记忆合金支架联合氩气刀对晚期食管癌的姑息性治疗,不仅可防治食管气管瘘、再狭窄,而且可改善患者的生活质量,并且上段距门齿17cm处支架置入成功,且证明是安全有效的。

[ Objective ] To research the treatment method of application of membrane covered self-expanding metallic stent combined with argon plasma coagulation （APC） to advanced esophageal carcinoma under endoscope. [ Methods] Membrane covered self-expanding metallic stent combined with APC was applied to treatment of advanced esophageal carcinoma under endoscope. [ Results ] In the 63 patients, the stents were successfully placed in 2 patients with upper esophageal carcinoma at a successful rate of 100%. The successful rates of stent placement were also 100% in 49 patients with middle esophageal carcinoma and 12 patients with lower esophageal carcinoma. [ Conclusion ] Membrane covered self-expanding metallic stent combined with APC under endoscope is an excellent palliative method for advanced esophageal carcinoma. It will not only improve the life quality of patients, but also prevent esophago-tracheal fistula and re-stricture. Stents can be successfully placed in the upper esophagus 17 cm from the fore-tooth. This method is proved to be safe and effective.