内镜姑息治疗食管癌性瘘47例

目的:探讨癌性食管瘘的有效治疗方法.方法:1998-2006病理证实的食管癌性瘘肿瘤患者47例,女3例,男44例,年龄29-92岁.食管癌42例,肺癌5例,全部存在食管瘘.10例伴有食管狭窄的患者先行内镜下食管扩张,随后行食管内带膜支架置入术.其余37例则直接行食管带膜支架置入术,并对其中瘘口较大者3例(超过1.5cm)附加蛋白胶黏堵.结果:患者的食管癌性瘘口即刻被封堵住,患者可进食进水,提高生活质量,延长生存期,70%(33/47)患者生存超过3 mo.结论:胃镜下食管内支架置入术或支架置入附加黏堵术为治疗支气管瘘的有效方法.

Palliative endoscopic therapy for cancer patients with esophageal fistula: an analysis of 47 cases

AIM:To find an effective treatment for advanced cancer patients with esophageal fistula. METHODS:From 1998 to 2006,we studied 42 patients with advanced esophageal cancer and 5 with carcinomatous esophageal fistula(3 females,44 males,aged 29-92 years old).Ten patients with both esophageal cancer stricture and fistula were first dilated by endoscopy,then a memory stent with a membrane was placed in the esophageal lumen.Others were treated with a memory stent with a membrane,three of whom with a large fistula(diameter>1.5 cm) were treated with bio-protein glue after place- ment of an esophageal metal tent. RESULTS:The fistulas were covered by a stent and the patients could eat and drink immediate- ly,their quality of life was improved and their survival was prolonged,with 44 of 47 patients living for>3 mo. CONCLUSION:Placement of esophageal stent with membrane was put in only or in combination with bio-protein through endoscope is an effective method for treating the branco-esophageal fistula.