关键词: 食管支架, 食管恶性狭窄, 记忆金属支架, wallstent支架, 生物相容性

Abstract:

OBJECTIVE: To explore the material characteristics of different types of esophageal stents and their clinical effect in advanced esophageal carcinoma patients complicated by malignant esophageal stenosis and esophageal fistula.
METHODS: A computer-based online retrieval was performed by the first author on China Academic Journals Full-text Database (CNKI) from 1999 to 2009 and Medline database (Pubmed) from 1997 to 2009 for articles related to the material characteristics of different types of esophageal stents and their clinical effect in advanced esophageal carcinoma patients complicated by malignant esophageal stenosis and esophageal fistula, Meta analysis and reproducible study were excluded, and a total of 22 articles were included. The results were analyzed with case.
RESULTS: With the developing techniques of the diagnosis and treatment, esophageal stent has achieved satisfactory results in the treatment of advanced esophageal carcinoma complicated by malignant esophageal strictures and esophageal fistula. The widely used esophageal stent materials are wallstent esophageal stent, “Z” shaped stent, memory metal stent, anti-reflux metal stent, and polyester plastic stent, etc. Seventy-one patients with advanced esophageal cancer were admitted to General Hospital of Fuxin Mining Group between November 2000 and October 2009, have achieving satisfactory results through esophageal stenting. After stenting, swallowing difficulties in patients have been alleviated quickly, and the effective rate was 100%. After stenting, patients exhibited different degrees of pains and foreign body sensation, which were almost tolerable. Three cases showed stent displacement and loss, 28 cases occurred gastroesophageal reflux, 1 died of bleeding 12 hours after implantation, and 18 cases exhibited long-term restenosis.
CONCLUSION: Different kinds of esophageal stent materials have its own advantages and disadvantages for the treatment of advanced esophageal cancer with esophageal malignant stenosis and esophageal fistula. Wallstent stent induces obvious foreign body sensation after stenting, but is not easy to shift. “Z” shaped stent is more suitable for diastrophic lesions and benign lesions, it can be easily adjusted and recycled, in addition, it can also reduce the incidence of stent restenosis. Memory metal stent is well biocompatible to tissues and soft, with mild foreign body sensation to patients. Anti-reflux stent significantly lowers the incidence of reflux.