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目的探索食管癌术后吻合口狭窄的治疗方法,评价食管支架置入术对它的疗效。方法本组35例食管癌根治术后吻合口狭窄的患者,吻合口狭窄0.00-0.60cm,平均0.25±0.12cm,其中合并吻合口瘘5例。无合并吻合口瘘者在支架置入术前2个月内已行食管扩张术2-5次无效或效果差,合并吻合口瘘者在支架置入术前未行食管扩张术治疗。在电视透视下定位,采取先球囊扩张,后支架置入,再球囊扩张的方法。结果支架置入的成功率100%。随访时间4.0-36.0个月,平均13.48±8.55个月。再狭窄率为8.57%(3/35),本组未发现支架脱落的病例,吻合口瘘全部被阻断、愈合,术后每个病例都有少量出血,胸痛、胸闷不适9例占2.57%(9/35),胃食管返流8例占22.9%(8/35),术后吞咽等级:0级:10例,1级:25例。结论食管支架治疗食管癌根治术后吻合口狭窄,方法简单,疗效确切,其并发症可采取防范措施,术后给予辅助治疗可减少或防止再狭窄的产生。
Objective To explore the treatment of esophageal cancer anastomotic stenosis and evaluate the effect of esophageal stent implantation on it. Methods 35 cases of esophageal cancer patients with anastomotic stenosis, anastomotic stenosis of 0.00-0.60cm, an average of 0.25 ± 0.12cm, which merged anastomotic fistula in 5 cases. Patients with no anastomotic leakage had 2 to 5 times of esophageal dilatation within 2 months prior to stent implantation, or were ineffective or poorly effective. Those with combined anastomotic leakage were treated with esophageal dilatation prior to stent implantation. Positioning in the television perspective, to take the first balloon dilation, stent implantation, and then balloon dilation method. Results The success rate of stent implantation was 100%. Follow-up time was 4.0-36.0 months, an average of 13.48 ± 8.55 months. Restenosis rate was 8.57% (3/35). No stent shedding was found in this group. All of the anastomotic fistulas were blocked and healed. There were 9 cases of chest pain and chest discomfort in 9 cases, 2.57% (9/35). Gastroesophageal reflux accounted for 22.9% (8/35) in 8 cases. The postoperative swallowing grade was grade 0: 10 cases and grade 1: 25 cases. Conclusion Esophageal stent treatment of esophageal cancer after radical anastomotic stenosis, the method is simple, the exact effect of its complications can take preventive measures, postoperative adjuvant therapy can reduce or prevent the restenosis.