Malignant dysphagia: Palliation with esophageal stents - Long-term results in 100 patients

被引:103
作者
Cwikiel, W
Tranberg, KG
Cwikiel, M
Lillo-Gil, R
机构
[1] Univ Lund Hosp, Dept Radiol, S-22185 Lund, Sweden
[2] Univ Lund Hosp, Dept Surg, S-22185 Lund, Sweden
[3] Univ Lund Hosp, Dept Oncol, S-22185 Lund, Sweden
[4] Univ Lund Hosp, Dept Thorac Surg, S-22185 Lund, Sweden
关键词
esophagus; grafts and prostheses; interventional procedure; neoplasms; stenosis or obstruction; stents and prostheses;
D O I
10.1148/radiology.207.2.9577503
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To evaluate the long-term palliative effect of self-expanding nitinol esophageal stents in patients with malignant dysphagia. MATERIALS AND METHODS: One hundred patients with severe dysphagia secondary to malignant esophageal strictures were treated with self-expanding nitinol stents. The strictures were caused by squamous carcinoma (n = 43), adenocarcinoma (n = 28), anastomotic tumor recurrence (n = 14), and mediastinal tumor (n = 15). RESULTS: One hundred six stents were successfully positioned in 100 patients. Attempts to insert a second, coaxial stent were unsuccessful in two patients; a second stent was placed incorrectly in another patient. Statistically significant (P<.001) reduction of dysphagia was noted after expansion of the stents. Complications consisted of incomplete expansion secondary to stent twisting (n = 4), stent migration (n = 4), tumor ingrowth (n = 17), tumor overgrowth (n = 3), food impaction (n = 5), fracture of stent wires (n = 2), benign strictures at stent edges (n = 2), tumor bleeding (n = 3), and esophagorespiratory fistula (n = 5). The primary patency rate was 75% (77 of 102 stents); the secondary patency rate was 94% (96 of 102 stents). The survival time (mean, 6.2 months; range 0.1-47 months) varied with the diagnosis. CONCLUSION: Placement of self-expanding nitinol stents is safe and has a good long-term palliative effect on dysphagia in patients with malignant esophageal strictures.
引用
收藏
页码:513 / 518
页数:6
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