结直肠癌(Colorectal cancer, CRC)是世界上第三大恶性肿瘤,也是癌症相关死亡的第二大原因。结直肠癌合并梗阻的概率达20%,常需要紧急处理,以免发生穿孔、出血等严重并发症。在过去,急诊手术是唯一可用的治疗方法,虽然可及时切除肿瘤,...结直肠癌(Colorectal cancer, CRC)是世界上第三大恶性肿瘤,也是癌症相关死亡的第二大原因。结直肠癌合并梗阻的概率达20%,常需要紧急处理,以免发生穿孔、出血等严重并发症。在过去,急诊手术是唯一可用的治疗方法,虽然可及时切除肿瘤,但却带来高死亡率和并发症率。自膨式金属支架(SEMS)自90年代问世以来,已经越来越多地作为一种微创治疗手段用于结直肠癌梗阻的治疗中。本文就SEMS的发展以及在结直肠癌伴肠梗阻中的应用进行综述。Colorectal cancer (CRC) is the third most common malignant tumor in the world and the second leading cause of cancer-related deaths. Colorectal cancer is associated with a 20% probability of obstruction and often requires emergency management to avoid serious complications such as perforation and bleeding. In the past, emergency surgery was the only available treatment, which allowed for timely removal of the tumor but entailed high mortality and complication rates. Since its introduction in the 1990s, the self-expanding metallic stent (SEMS) has been increasingly used as a minimally invasive treatment in the management of colorectal cancer obstruction. This article reviews the development of SEMS and its application in colorectal cancer with bowel obstruction.展开更多
恶性胆道梗阻主要是由各种恶性疾病包括胆管癌、胰腺癌、壶腹癌和继发于淋巴结的转移性癌症等外部压迫而引起。而持续阻塞性黄疸不仅损害患者的生活质量,也可能导致严重的并发症,包括肝脏和肾功能衰竭。自1979年的内窥镜支架引入以来,...恶性胆道梗阻主要是由各种恶性疾病包括胆管癌、胰腺癌、壶腹癌和继发于淋巴结的转移性癌症等外部压迫而引起。而持续阻塞性黄疸不仅损害患者的生活质量,也可能导致严重的并发症,包括肝脏和肾功能衰竭。自1979年的内窥镜支架引入以来,恶性胆管梗阻患者的管理发生了彻底的改变。内窥镜与胆道支架的结合应用不仅适用于术前胆道引流以改善黄疸患者的围手术期症状,现也通常作为不可切除恶性胆道梗阻的姑息性治疗方式。目前,在不可切除的恶性胆道阻塞中,超声内镜(endoscopic ultrasonography,EUS)引导下新型哑铃样金属支架(lumen-apposing metal stents,LAMS)置入引流逐渐被提议为内镜逆行胰胆管造影姑息性胆道引流不可行或失败患者的最新替代方式[1-2]。本文旨在对自膨式金属胆道支架在恶性胆道梗阻-胆道引流治疗中的应用与进展进行综述。展开更多
文摘结直肠癌(Colorectal cancer, CRC)是世界上第三大恶性肿瘤,也是癌症相关死亡的第二大原因。结直肠癌合并梗阻的概率达20%,常需要紧急处理,以免发生穿孔、出血等严重并发症。在过去,急诊手术是唯一可用的治疗方法,虽然可及时切除肿瘤,但却带来高死亡率和并发症率。自膨式金属支架(SEMS)自90年代问世以来,已经越来越多地作为一种微创治疗手段用于结直肠癌梗阻的治疗中。本文就SEMS的发展以及在结直肠癌伴肠梗阻中的应用进行综述。Colorectal cancer (CRC) is the third most common malignant tumor in the world and the second leading cause of cancer-related deaths. Colorectal cancer is associated with a 20% probability of obstruction and often requires emergency management to avoid serious complications such as perforation and bleeding. In the past, emergency surgery was the only available treatment, which allowed for timely removal of the tumor but entailed high mortality and complication rates. Since its introduction in the 1990s, the self-expanding metallic stent (SEMS) has been increasingly used as a minimally invasive treatment in the management of colorectal cancer obstruction. This article reviews the development of SEMS and its application in colorectal cancer with bowel obstruction.
文摘恶性胆道梗阻主要是由各种恶性疾病包括胆管癌、胰腺癌、壶腹癌和继发于淋巴结的转移性癌症等外部压迫而引起。而持续阻塞性黄疸不仅损害患者的生活质量,也可能导致严重的并发症,包括肝脏和肾功能衰竭。自1979年的内窥镜支架引入以来,恶性胆管梗阻患者的管理发生了彻底的改变。内窥镜与胆道支架的结合应用不仅适用于术前胆道引流以改善黄疸患者的围手术期症状,现也通常作为不可切除恶性胆道梗阻的姑息性治疗方式。目前,在不可切除的恶性胆道阻塞中,超声内镜(endoscopic ultrasonography,EUS)引导下新型哑铃样金属支架(lumen-apposing metal stents,LAMS)置入引流逐渐被提议为内镜逆行胰胆管造影姑息性胆道引流不可行或失败患者的最新替代方式[1-2]。本文旨在对自膨式金属胆道支架在恶性胆道梗阻-胆道引流治疗中的应用与进展进行综述。