被膜食管支架治疗食管贲门良性狭窄32例

Treatment of benign esophageal and cardial stricture with covered esophageal stents:an analysis of 32 cases

目的:评价被膜食管支架治疗食管贲门良性狭窄的疗效和安全性.方法:选择食管贲门良性狭窄患者32例,根据不同患者选择合适的被膜食管支架置入狭窄段.观察操作成功率、吞咽困难改善情况、术中术后并发症的发生及其处理等.结果:32例均一次性成功置入支架,支架置入后吞咽困难症状均得到持续改善.所有患者未出现食管穿孔、出血等严重并发症,但均出现不同程度的胸骨后闷胀隐痛不适,其中4例患者胸痛较明显,肌注止痛剂后缓解;3例出现支架脱落;1例出现支架近端肉芽组织增生.支架置入后可有效封闭食管气管瘘、食管纵隔瘘等.术后6mo可经内镜成功取出支架.结论:内镜下置入被膜食管支架是治疗食管贲门良性狭窄的一种安全、有效的方法.

AIM：To evaluate the efficacy and safety of covered esophageal stents for the treatment of benign esophageal and cardial stricture.METHODS：Thirty two patients with benign esophageal and cardial stricture were selected.Appropriate stents were inserted depending on particular patient＇s condition.The success rate of stent insertion,the improvement in swallow function,the complications and their management were recorded.RESULTS：Stents were placed successfully in all patients.Dysphagia was resolved persistently in all patients after stent placement.No serious complications,such as esophageal perforation,and massive hemorrhage,occurred.However,all patients suffered varying degrees of chest pain.Four patients developed severe chest pain but got relieved after intramuscular injection of analgesics.Stent migration occurred in 3 patients.Granulation tissue hyperplasia at the proximal portion of the stent occurred in one patient.Esophageal fistula can be closed after stent placement.Stents could be removed successfully under endoscopic assistance six months after stent placement.CONCLUSION：Covered esophageal stent insertion is a safe and effective treatment for benign esophageal and cardial stricture.