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首页> 外文期刊>Radiology >Malignant esophageal obstruction and esophagorespiratory fistula: palliation with a polyethylene-covered Z-stent.
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Malignant esophageal obstruction and esophagorespiratory fistula: palliation with a polyethylene-covered Z-stent.

机译：恶性食管梗阻和食管呼吸性瘘管：用聚乙烯覆盖的Z型支架缓解。

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PURPOSE: To prospectively evaluate the clinical efficacy of polyethylene-covered metallic Z-stents in treatment of dysphagia secondary to malignant esophageal obstruction and esophagorespiratory fistula. MATERIALS AND METHODS: Thirty-five patients with dysphagia due to malignant esophageal obstruction (n = 32) and esophagorespiratory fistula (n = 3) were treated with polyethylene-covered Gianturco-Rosch Z-stents. RESULTS: Thirty-nine stents were placed in 35 patients. Stent placement was technically successful in all patients. Improvement in dysphagia was achieved in 34 of 35 patients. The average dysphagia score decreased from 3.1 (dysphagia to liquids) to 0.6 (essentially normal diet). An esophagorespiratory fistula was completely sealed in two of three patients. All 35 patients were followed up clinically at 1 day and 1 week and at 3-month intervals (range, 1 week to 18 1/2 months; mean, 4.8 months). Recurrent dysphagia or aspiration occurred in only three of 34 (9%) patients whose disease was initially palliated and was easily treated in all cases. Nine complications occurred in eight patients (23%) and included chest pain that required analgesia (n = 3), food impaction (n = 1), stent migration (n = 2), and upper gastrointestinal tract hemorrhage (n = 3). CONCLUSION: Polyethylene-covered stents are a relatively safe and effective means of long-term palliation in patients with severe malignant esophageal obstruction and esophagorespiratory fistula. These stents are easily deployed, and the rate of stent migration is relatively low.
机译：目的：前瞻性评估聚乙烯覆盖的金属Z型支架治疗恶性食管阻塞和食管呼吸道瘘所致吞咽困难的临床疗效。材料与方法：对35例因恶性食管梗阻（n = 32）和食管呼吸道瘘（n = 3）而引起的吞咽困难的患者进行了聚乙烯覆盖的Gianturco-Rosch Z支架治疗。结果：35例患者中置入了39个支架。从技术上讲，所有患者均成功置入支架。 35名患者中有34名吞咽困难得到改善。平均吞咽困难评分从3.1（吞咽困难到流质）降低到0.6（基本上是正常饮食）。在三名患者中的两名患者中，食道呼吸瘘被完全封闭。所有35例患者均在1天和1周以及3个月的时间间隔（范围1周至18 1/2个月;平均4.8个月）进行临床随访。复发性吞咽困难或误吸仅在34例患者中有3例（9％）发生，最初被缓解，在所有情况下均易于治疗。 8名患者（23％）发生9处并发症，包括需要镇痛的胸痛（n = 3），食物撞击（n = 1），支架移位（n = 2）和上消化道出血（n = 3）。结论：覆有聚乙烯的覆膜支架对于严重恶性食管梗阻和食管呼吸道瘘管患者而言是一种较长期安全且有效的手段。这些支架易于部署，并且支架的迁移率相对较低。

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