自动膨胀型金属支架治疗晚期食管癌

目的 评价自动膨胀型金属支架对不能切除的食管和贲门恶性肿瘤患症状的缓解作用，评价金属支架置入的安全性，观察姑息性治疗的近期和远期疗效。方法 27例食管、贲门恶性肿瘤和食管胃吻合术后复发的患，用萨氏扩张器治疗后，在食管和贲门狭窄处放置自动膨胀型金属支架。结果 27例首次治疗后吞咽困难改善致少2级。住院并发症发生率7.4%(2/27)，住院死亡率为7.4%(2/27)。支架通畅期大于3个月为85.2%(23/27)，大于6个月为59.3%(16/27），大于12个月为29.6%(8/27)。结论 自动膨胀型食管支架置放术是一种安全的姑息治疗方法，宽大的直径和强大的扩张力能够防止支架移位及肿瘤的过度生长，使大多数患的症状在短期内得到缓解，支架的柔韧性有利于将其置入弯曲而且有角度的狭窄处，并发症和死亡率较低，是治疗癌性吞咽困难的一种有价值的方法。

Treatment of advanced esophageal cancer with self-expanding metallic stent

Objective To evaluate the effect and the safety of the self expanding metallic stent for palliation in patients with non resectable malignant tumors of the esophagus or cardia and to observe the early and late curative effect of palliative treatment.Methods All 27 patients with malignant esophageal or cardiac neoplasm and recurrent patients after esophagogastric anastomosis were treated with Savary Gilliard dilation and then inserted with self expanding metallic stents into the strictures of the esophagus and cardia.Results After opration,dysphagia was improved at least 2 degrees in 27 patients.Overall hospital morbidity was 7.4%(2/27),Hospital mortality was 7.4%(2/27).Open term of the stent over 3 months was 85.2%(23/27),over 6 months was 59.3%(16/27),over 12 months was 29.6%(8/27).Conclusion Intubation of self expanding metallic stents is a safe and palliative procedure.The stent has a wide diameter and strong forces of expansion,which may prevent itself from movement and tumor overgrowth.Its considerable flexibility facilitates the insertion of the stent into tortuous and angulated passages.Intubation can be performed with low morbidity and mortality.Esophageal stenting is a valuable treatment in the management of malignent dysphagia.