食管小球囊或乳头括约肌切开刀在结直肠癌性梗阻支架置入术中的应用

目的：探寻在结直肠癌并完全梗阻患者中以食管小球囊或乳头括约肌切开刀辅助置入结直肠支架的方法，以提高置入的成功率。方法：对49例结直肠癌并完全梗阻或结直肠癌处于成角明显部位的患者，以食管小球囊或乳头括约肌切开刀辅助导丝，采用导丝球囊递进的方法，将导丝逐步越过肿块间隙并置于对侧肠腔，以X射线确认导丝置入病变口对侧肠腔后，置入金属裸支架。结果：49例采用常规方法无法通过导丝的患者均成功插入导丝，顺利置入支架。结论：对于肿块完全堵塞肠腔或成角明显部位的结直肠癌性梗阻，使用能通过导丝的食管小球囊或乳头括约肌切开刀辅助，可使导丝插入更为容易，提高支架置入的成功率。

Use of esophageal small balloon or papillary sphincter knife in the treatment of stent implantation for colorectal malignant obstruction

Objective: To explore the function of esophageal small balloon or papillary sphincter knife in thetreatment of stent implantation for colorectal malignant obstruction, and to improve the successrate of colonic stent placement in such patients.Methods: A total of 49 patients with colorectal cancer complicated with almost completeobstruction or colorectal cancer were enrolled for this study. The esophageal small balloon orpapillary sphincter knife was used in the guide wires. Th e guide wires gradually crossed the tumorgap and they were placed in the contralateral intestinal cavity with balloon progression. X-ray wasthen used to confi rm whether the guide wire was inserted in the lesion intestinal cavity, and thenthe metal bare stent was inserted.Results: The guide wires was successfully inserted with conventional methods in these 49 cases,while they were also successfully placed the guide wire and the stent in the new way.Conclusion: For the patients with colorectal cancer complicated with complete obstruction orcolorectal cancer located in obviously angled location, the use of esophageal small balloon orpapillary sphincter knife can help the guide wire insert. They greatly improve the success rate ofstent implantation.