摘要
目的:评价食管支架治疗食管癌术后吻合口狭窄的临床疗效,探讨食管支架留置的适应症。材料与方法:对36例食管癌术后吻合口狭窄患者进行食管内支架治疗,其中男30例,女6例,年龄39～84岁(平均58岁)。36例中瘢痕狭窄20例,术后肿瘤复发狭窄16例,其中合并食管气管瘘2例,食管纵隔瘘2例,食管胸腔瘘1例。瘢痕狭窄选择国产网状镍钛合金支架,肿瘤复发狭窄及合并瘘道者选择带膜支架。透视下先对狭窄段进行扩张,再推送、释放支架。结果:36例支架均一次性留置成功,操作顺利,无术中并发症。术后一周内均有胸骨后疼痛和胸骨后异物感,一般可忍受。术后所有患者吞咽困难症状明显改善,瘘口愈合。术后4例发生再狭窄,3例由于肿瘤生长超过支架覆盖范围所致,1例由于粘膜增生所致,其中2例行二次支架治疗后吞咽困难症状缓解。结论:食管支架是治疗食管癌术后吻合口狭窄的一种安全有效的方法,瘢痕狭窄反复球囊扩张无效、肿瘤复发狭窄及合并瘘道者是留置支架的适应症。
Objective:To evaluate the clinical efficacy of self-expanding metallic stent(SEMS)in treatment of anatomotic strictures and fistulas after esophogogastric anastomasis.Materials and Methods:Thirty-six anatomotic strictures and fistulas were treated with SEMS under TV fluoroscopic guidance.Results:Successful stent placement was achieved in all cases at one stroke.Fistulas was completely sealed in five patients.All patients had made significant improvement in dysphasia.Restenosis oc-curred in four patients including tumor over-growth in three and hyperplasia of granulation tissue in one which were success-fully treated by inserting the second stent.Conclusion:SEMS are a relatively safe and effective means in the management of anatomotic strictures after esophagogastric anastomosis.
出处
《中国临床医学影像杂志》
CAS
2002年第3期172-173,189,共3页
Journal of China Clinic Medical Imaging
关键词
食管肿瘤
支架
放射学
介入性
esophageal neoplasms
stents
radiology,interventional
