内镜下自膨式无覆膜结肠金属支架置入治疗左侧结肠恶性梗阻

目的 探讨经内镜自膨式无覆膜金属支架置入治疗左侧结肠癌性梗阻的临床价值.方法 根据梗阻情况进行不同术前肠道准备后,经内镜放置金属支架治疗左侧结肠癌性梗阻患者21例,术后进行常规处理并随访.结果 21例结肠癌性梗阻中,放置金属支架成功率为100％,术后1～2d肠梗阻症状均得到缓解或消除；支架术后均有少量的便血6例,无大出血、穿孔及支架移位等并发症发生；21例患者术后均能恢复经口进食,生存期4 ～ 22月,平均生存期为7月.结论 经内镜放置自膨式无覆膜金属支架治疗左侧结肠癌性梗阻,操作简单、经济有效、术后并发症少,有效缓解患者的梗阻症状,提高其生活质量.

Treatment of Left Malignant Colonic Obstruction by Endoscopic Self-expandable Non-coated Metal Stent

Objective To study the clinical value of the endoscopic self-expandable non-coated metal stent for the treatment of left colon obstruction.Methods 21 cases of patients with left colon cancer obstruction were placed endoscopic metal stent.All patients were followed up after conventional treatment.Results The success rate of metal stent placement was 100%.Symptoms of intestinal obstruction alleviated or disappeared in 1~2 days post-operation.6 cases(6/21) had a small amount of blood in the stool post-operation and no case was found of bleeding,perforation,and stent migration and other complications.All patients resumed oral feeding and the survival time ranged from 4 to 22 months with the mean time of 7 months.Conclusion Endoscopic self-expandable non-coated metal stent is a simple and effective treatment for malignant left colonic obstruction with cost-effective and less postoperative complications.