内镜测距盲推置入覆膜食管支架治疗晚期食管癌的临床疗效（附182例报告）

Clinical efficacy of advanced esophageal cancer treated with esophageal stent placement by endoscopic distance measurement and blind push insertion (182 cases)

摘要:

目的 探讨内镜测距盲推置入覆膜食管支架治疗晚期食管癌的临床疗效。方法 回顾分析2014年1月－2023年12月该院采用内镜测距盲推置入覆膜食管支架治疗的182例晚期食管癌患者的临床资料。观察操作时间、患者舒适度、支架置入位置是否准确、术后出血和胸痛等情况。结果 182例均成功置入支架，平均置入时间（11.0±4.0）min，支架位置较预期位置相差的距离≤0.5 cm，术后6 h进食半流质，置入过程中，未出现明显恶心、呕吐和呛咳等症状，术后出血25例，发生率为13.7%，不需要静脉麻醉，术后未发生穿孔，术后胸痛发生率为82.4%，患者吞咽困难得到明显缓解。结论 内镜测距盲推置入覆膜食管支架用于晚期食管癌伴食管梗阻患者，具有操作简便、支架位置准确、并发症少和患者不适感轻等优点，可作为临床食管支架置入的一种新选择。

Abstract:

Objective To investigate the clinical efficacy of placing a covered esophageal stent by blind pushing method under endoscopic distance measurement in the treatment of advanced esophageal cancer.Method Clinical data of 182 patients with advanced esophageal cancer who were treated by the above method from January 2014 to December 2023 were retrospectively analyzed, and the situations of operation time, patient comfort, accuracy of stent placement, postoperative bleeding, and postoperative chest pain were observed.Result All 182 patients with advanced esophageal cancer were successfully implanted with the covered esophageal stent by the blind pushing method under endoscopic distance measurement. The average placement time was (11.0 ± 4.0) min, and the position of the stent was within 0.5 cm of the expected position. The patients could eat semi-liquid food within 6 h after the operation. No obvious symptoms such as nausea, vomiting and choking cough occurred during the implantation process. Postoperative bleeding was observed in 25 patients (13.7%). No intravenous anesthesia was required, no perforation occurred after the operation, the incidence of postoperative chest pain was documented at 82.4%. The dysphagia problem of the patients was significantly alleviated.Conclusion The endoscopic distance measurement and blind push insertion demonstrate advantages of procedural simplicity, accurate positioning, reducing procedure-related complications, and minimal patient discomfort in patients with advanced esophageal carcinoma and obstruction, establishing its clinical applicability as a novel approach for esophageal stent placement.