急性左半结肠癌性梗阻的金属支架置入治疗

Treatment of acute left sided malignant colonic obstruction using metallic stent implantation

目的探讨肠道金属支架治疗左半结肠癌性梗阻的临床疗效。方法左半结肠癌性梗阻25例,17例有手术切除机会的患者为临时治疗组,临时置入支架解除梗阻并充分肠道准备后行外科手术。8例有明显手术禁食的患者为姑息治疗组,置入支架作为永久性治疗。结果临时治疗组17例均置入结肠金属支架,其中1例因肠穿孔行急诊手术,余梗阻缓解后顺利接受手术治疗。姑息治疗组8例,均置入结肠金属支架,其中1例因支架释放不满意,再置入一枚支架后症状缓解。结论肠道金属支架能有效缓解左半结肠梗阻,为晚期肿瘤患者提供安全有效的姑息性治疗方法并为临床手术切除创造条件。

【Objective】To investigate the clinical effect of intestines metallic stent in the treatment of left sided malignant colonic obstruction.【Methods】 25 cases of left sided malignant colonic obstruction were enrolled in our study.17 cases could accept the surgical resection were divided into temporary treatment group,received temporary stent placement to relieve obstruction and underwent the surgical operation after adequate intestinal preparation.8 cases had obvious surgery fasting were divided into palliative treatment group,stenting was the permanent treatment.【Resluts】 In temporary treatment group,1 case had the emergency operation due to intestinal perforation.16 cases had operation successfully after relief of obstruction.In palliative treatment group,1 case had to have another stenting to improve symptoms due to original stent release was not satisfied.【Conclusion】Left sided malignant colonic obstruction can be relieved effectively by intestines metallic stent.It can provide safe and effective palliative treatment for the later period tumor patients,and create the condition for surgical resection.