食管癌放疗后狭窄食管内支架治疗方法的探讨

目的　评价食管内支架治疗食管癌放疗后狭窄的临床效果及方法探讨。方法　本组 3 6例食管癌放疗后狭窄的患者 ,其中食管 -纵隔瘘 4例 ,食管 -气管瘘 5例 ,食管 -纵隔 -气管瘘 1例。 40枚食管内支架置入均在X线电视监视下进行 ,术后给予抗生素、止血药及镇静止痛药。结果　 3 6例患者均成功置入 ,其中 4例置入 2枚支架 ,1例食管气管瘘合并气管狭窄者先置入气管支架 1枚后置入食管支架 ,所有患者术后吞咽困难完全消除或明显缓解 ,食管 -气管或纵隔瘘完全封闭。 1～ 12月随诊观察 ,应用支架直径 1.8cm以上的患者 ,术后反应较大 ,并发症较多。结论　食管内支架治疗食管癌放疗后狭窄 ,选用直径 1.8cm以下的支架 ,更为安全、有效

Metallic Stent Implantation for the Treatment of Postradiation Stricture of Esophageal Cancer

Objective To evaluate metallic stent implantation for the treatment of esophageal cancer postradiation stricture.Methods Metallic stents were set in 36 patients,of them,there were 4 esophago-mediastinal fistula, 5 esophago-tracheal fistula and 1 esophago-mediastinal-tracheal fistula , and nickel-titanium heat-memory binary alloy were used. 40 stents implantation were monitored under fluoroscopy .Results Stent implantation was succeeded in all 36 cases, of them , two stents were set in four patient respectively. Tracheal stent was implanted in one patient with esophago-tracheal fistula before implanted esophageal stent. Dysphagia were markly improved or completely alleviated with esophago - mediastinal fistula and esophago-tracheal fistula sealed completely after the procedures.Conclusion The diameter of esophageal stent seldom exceeding 1.8 cm is more safe and effective therapy for the treatment of esophageal cancer postratiation stricture.