自膨式覆膜支架在食管恶性狭窄及食管气管瘘中的应用  

Self-expandable covered esophageal stent for the treatment of malignant esophageal stenosis and esophago-tracheal fistula

作　　者：陈泓磊[1] 刘亚男[1] 伍秋宁 林绪涛[1] 范德军[1] 李初俊[1] CHEN Hong-lei;LIU Ya-nan;WU Qiu-ning;LIN Xu-tao;FAN De -jun;LIChu-jun(Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital of Sun Yat-sen University,Guangdong Province Guangzhou, 510000, China)

机构地区：[1]中山大学附属第六医院消化内镜科,广东广州510000

出　　处：《消化肿瘤杂志（电子版）》2017年第4期248-251,共4页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨内镜下自膨式覆膜食管支架置入术治疗食管恶性狭窄及食管气管瘘的临床应用价值。方法回顾性分析我院2013年4月至2017年6月30例经内镜置入覆膜食管支架治疗食管癌性狭窄及食管气管瘘患者的临床资料,分析支架置放成功率、术后并发症、患者临床症状改善情况。结果30例患者均一次性成功置入支架,成功率为100%。其中4例患者为食管癌性狭窄并食管-支气管瘘。9例患者由于食管过于狭窄先行内镜下食管扩张,再行放置食管支架。有3例支架置入术后发生再狭窄,行氩气刀切开后再通。1例患者出现支架移位。术后患者均有不同程度胸痛,但无穿孔、出血等严重并发症。术后患者进食能力提高,食管气管瘘闭合。结论内镜下自膨式覆膜食管支架置入术是治疗晚期食管癌性狭窄及食管气管瘘的安全有效方法。Objective To investigate the clinical effectiveness of self-expandable covered esophageal stent in the treatment of malignant esophageal stenosis and esophago-tracheal fistula and its related complications. Methods This study retrospectively evaluated 30 patients with malignant esophageal stenosis and esophago-tracheal fistula who underwent placement of self-expandable covered esophageal stent at our hospi-tal from April 2013 to June 2017. Clinical data were collected to analyze technical success, clinical outcome as well as complications. Results Among those 30 patients, four were with esophageal stenosis complicated by esophago-tracheal fistula,The self-expandable covered esophageal stents were implanted successfully in all patients. Recurrent dysphagia was noticed in three patients, all of which were successfully treated with ar-gon plasma coagulation. Stent migration was seen in one case. Chest discomfort in various degrees was the most common experience while no serious complications such as rupture or hemorrhage were observed. Eating capacity was improved and esophago-tracheal fistula healed after stent implantation. Conclusion Endoscopic self-expandable covered esophageal stent placement seems to be a safe and effective treatment option for advanced esophageal stenosis and esophago-tracheal fistula.

关 键 词：胃镜覆膜支架 食管癌 狭窄 食管气管瘘 

分 类 号：R735.1[医药卫生—肿瘤]