自膨式带膜食管支架在食管良性狭窄中的应用

目的通过对自膨式带膜食管支架在食管良性狭窄中的应用,进一步明确其适应症及方法。方法共34例患者,因食道癌术后吻合口狭窄18例,食道癌放疗术后8例,食道烧伤3例,脊柱手术2例,门奇断流术后3例,治疗前吞咽困难均为3级。所用器械3-12#沙氏扩张器一套,0.035寸直径,1.8米导丝1根。支架推送器,50-120mm自膨式带膜支架。全部在电视透视下进行,局部口咽部及食道表面麻醉。结果34例均一次放置成功,其中有一例高位食道癌因放置后疼痛难忍,48小时内取出,1例食道下段放置后掉入胃腔,手术取出,放置后吞咽困难降至零级,有效率100％,随访2年有5例出现局部肉芽生长,在食道镜下电切均再通。结论自膨式带膜食管支架治疗食道良性狭窄安全有效无痛苦。

Application of Self- expandable and Covered Metallic Stent Implantation in the Treatment of Esophageal stricture

Objective To evaluate the self-expandable and covered metallic stent in treating of esophageal stricture due to various causes.Methods 34 cases were collected in this study,18 were esophageal fistula,8 carcinoma of esophagus following radiotherapy,3 bum of esophagus,5 other esophageal stenosis.Home-made covered Ni-Ti wire mesh-like stents were used in the treatment of e-sophageal stricture.The manipulation of stent implantation was monitored under fluoroscopy.Results Stent implantation was succeeded by single procedure in all 34 cases.The severity of dysphagia was reduced,on the average,from degree 3 to degree 0.Stent slipping was seen in one case and retrostemal pain in one.Patients were followed up more than 6 months,of which granulation could be seen with 5 cases following 2 years and needing electrotomy.Conclusion Implantation of self-expandable and covered metallic stent is a safe and effective therapy for the treatment of various esophageal strictures.