食管癌性狭窄及食管支气管瘘应用自膨式金属支架治疗的疗效观察

本文报道23个带有硅酮被膜自膨式金属G－RZ型内支架在18例食管癌性狭窄和食管支气管瘘中的应用结果。在X线透视下经口腔放置，全部成功，未发生技术性并发症或死亡。放置24－48小时后，吞咽程度由术前平均3．5级降至0．5级，均能进普食或较食。全组4例出现并发症，其中2例内支架移位，2例食物嵌塞。随访观察1-6个月，16例仍存活，2例死于心衰和肿瘤转移。内支架均保持通畅。结果提示，食管自膨式金属内支架放置操作简单、安全，是治疗食管癌性狭窄和食管支气管瘘有效的保守疗法。

The Effects of Self-Expanding Metallic Stents in Treating Malignant Esophageal Stenosis and Esophagotracheal Fistula

This article reports the effects of malignant esophageal stenosis and esophagotracheal fistulae in 18patients treated with 23 modified silicone coated Gianturco-Rsch self-expanding metallic Z stents. All stentswere placed with fluroscopic guidance without any technical failure or procedure morbility or mortality. 24 to 48hours after placement, dysphagia was improvement in 18 patients. Defined by a decrease of about 5 dysphagia gra-des, the mean dysphagia grade fell from 3.5 to 0.5. All patients could ingest solid or semi-solid food.Complicationsoccurred in 4/18 patients, included stent migration(2 patients), food impaction (2 patients). After 1-6 months fol-low-up, 16 patients were still alive, one died of heart failure,another died from cancer metastasis, and all stentswere unobstructed. Our observation indicates that self-expanding metallic stents are easy to insert, safe and effec-tive for palliative treatment of esophageal stenosis and esophagotracheal fistulae.