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首页> 外文期刊>Surgical Endoscopy >Performance status is a predictive factor of dysphagia improvement after esophageal stenting in patients with malignant esophageal strictures and fistulas
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Performance status is a predictive factor of dysphagia improvement after esophageal stenting in patients with malignant esophageal strictures and fistulas

机译：性能状况是恶性食管狭窄和瘘管患者食管支架后吞咽困难改善的预测因素

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Background Malignant strictures and fistulas of the esophagus adversely affect quality of life (QOL) and prognosis, and stenting is considered a useful therapy for improving QOL. However, the predictive factors for improving dysphagia after esophageal stenting are unclear. This retrospective cohort study aimed to evaluate patients with esophageal malignant strictures and fistulas who underwent stenting and investigate the factors for dysphagia improvement after stenting. Methods Twenty-four patients with malignant esophageal strictures and fistulas were treated with a self-expandable metallic stent over a period of 5 years and 6 months. The main outcome was improvement in the dysphagia score. We divided the patients into dysphagia improved and non-improved groups after esophageal stenting. Sex, age, cause of stenting (primary or non-primary esophageal cancers), prior treatments, such as chemotherapy and radiation, type of esophageal stents (covered or non-covered), dysphagia score before stenting, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) of the patients before stenting were evaluated. Student's t test and Fisher's exact test were used for continuous and categorical variables, respectively. Factors with a P value < 0.2, age, and sex were included and evaluated using a multiple logistic regression model. Statistical significance was defined as a P value < 0.05. Results Stent placements succeeded in all cases without fatal complications. The dysphagia score improved in 15 patients. Twelve patients had primary lesions, and another 12 had non-primary lesions. The reasons for stenting were malignant strictures in 20 patients and esophageal fistulas in 4 patients. There were no significant differences in any factors, except PS before stenting (P = 0.003), between the improved and non-improved groups. Multiple logistic regression analysis results demonstrated that improvement in the dysphagia score was significantly associated with PS before stenting (adjusted odds ratio = 0.035, 95% CI 0.003-0.44, P = 0.009). Conclusions Esophageal stenting is safe and effective in patients with malignant esophageal strictures and fistulas. PS is an independent factor for dysphagia improvement after stenting.
机译：背景的背景恶性狭窄和食道的瘘管对生命质量（QOL）和预后产生不利影响，并且支架被认为是改善QOL的有用疗法。然而，在食管支架后改善吞咽困难的预测因素尚不清楚。这种回顾性队列研究旨在评估患有食管恶性狭窄患者的患者，并探讨支架后吞咽困扰改善的因素。方法采用24例恶性食管狭窄患者，在5岁和6个月内用自膨胀金属支架治疗。主要结果是吞咽困难评分的改善。我们将患者划分为食管支架后吞咽困难和未改进的群体。性别，年龄，支架原因（初级或非初级食管癌），现有治疗方法，如化疗和辐射，食管支架（覆盖或未覆盖），吞咽症和东方合作肿瘤组（ECOG）评估支架前患者的性能状态（PS）。学生的T测试和Fisher的确切测试分别用于连续和分类变量。使用多个逻辑回归模型，包括P值<0.2，年龄和性别的因素。统计显着性定义为P值<0.05。结果在所有病例中成功地成功了没有致命并发症的展示。困扰评分在15名患者中得到改善。 12名患者患有初级病变，另外12例具有非原发病变。在4名患者中，20例患者和食管瘘中的延期原因是恶性狭窄。在改进和未改进的组之间，任何因素没有显着差异，除了PS之前PS（p = 0.003）。多重逻辑回归分析结果表明，在支架之前，吞咽困难评分的改善与PS显着相关（调节的差距= 0.035,95％CI3-0.44，P = 0.009）。结论食管支架对恶性食管狭窄和瘘管患者安全有效。 PS是支架后吞咽困难改善的独立因素。

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