内支架治疗结直肠癌急性梗阻

Self-expanding metallic stent in the treatment of acute colorectal obstruction caused by malignancies

目的 探讨结直肠癌急性梗阻的金属内支架治疗的效果和安全性。方法 对 2 0 0 0年 5月～ 2 0 0 3年 6月收治的结直肠癌急性梗阻 15例进行临时性或姑息性内支架治疗 ,并观察梗阻缓解情况和并发症。结果 15例中 12例 (80 .0 % )内支架放置成功 ,全组无死亡发生 ,2 4h内临床梗阻缓解率 10 0 % (12 / 12 )。并发支架移位和肛门疼痛各 1例。 8例经过肠道准备和全身支持治疗后行根治性手术 ;4例内支架置放系永久性姑息性治疗。结论 内支架治疗对左半结肠或直肠急性癌性梗阻是一种安全有效的临时性或永久性姑息性治疗手段 ,可免除急诊结肠造瘘术。

Objective To determine the effect and safety of metallic stents in the treatment of acute malignant colorectal obstruction.Methods From May,2000 to June,2003, self-expanding metallic stents were implanted in 15 patients with acute left colonic obstruction caused by malignancies. The postoperative remission and complications were observed.Results Stents were implanted successfully in 12 cases(80.0%,12/15).Of the 12 cases,the obstruction were all disappeared within 24h. No death or colonic perforation happened in this series. Stent migration and anal pain developed each in one case after stent implantation. Elective radical resection was performed on 8 cases after bowel preparation and supportive therapy; and stents reserved permanently in other 4 cases. Conclusions The implantation of self-expanding metallic stents is a safe and effective method for the temporary remission or permanent treatment of acute left-colonic or rectal obstruction caused by malignancies,it can instead of colostomy.