新型可降解支架治疗食管吻合口瘘的疗效分析

Novel Esophageal Stent for Treatment of Anastomotic Leakage

目的:评价新型生物可降解支架治疗颈部食管吻合口瘘的效果,为治疗食管吻合口瘘提供理论依据。方法:将成年健康新西兰大白兔采用切开吻合置管造瘘法建立颈部食管吻合口瘘的动物模型,1周后,食管造影确定食管瘘口完成。完全随机分组,空白对照组(A组,n=5),对照组(B组,n=5)和实验组(C组,n=5)。实验组使用生物可降解支架封闭瘘口,而对照组应用同规格不可降解支架封堵食管瘘口。植入后每周行食管造影,观察支架及瘘口情况,植入后8周为实验终点。结果:本研究成功建立了兔颈部食管吻合口瘘的动物模型,至实验终点,普通支架组,支架覆盖瘘口,未发生支架移位及穿孔等现象。新型可分解支架组,3例支架分别在支架植入后5-8周分解,发生移位。实验组与对照组闭合率无统计学意义(4/5比3/5,P>0.05)。结论:新型生物可降解支架支架是治疗食管吻合口瘘的一种有效方法。

Objective： To assess the safety and effectiveness of the biodegadeble stent in the management of esophageal anastomotic leakage. Methods： A total of 15 rabbits＇ models of anastomotic leakage were randomly divided into a control group（A group,n=5, no stent insertion）, a plastic stent group（B group, n=5）, and degradeble stent group（C group, n=5）, then underwent stent insertion to cover the leakage. Esophagography was performed every week. Results： Stent insertion was well tolerated. Biodegradable stents migrated in three rabbits, and there was no stents migrated in plastic group. Esophageal wall remodeling was similar in biodegradable and plastic stent groups. Esophageal injury and collagen deposition following stent insertion were similar and there was no difference.Conclusions： Esophageal biodegradable stents could provide reliable support, with acceptable migration rates and provide a new method for treatment of anastomotic leaks.