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Gastrointestinal Oncology - part 8

Một nghiên cứu gần đây so sánh làm cho khác nhau của ống đỡ động mạch thực quản (Ultraflex ống đỡ động mạch, Zstent, và Flamingo Wallstent [Châu Âu]) cho hiệu quả và an toàn trong 100 bài liên tiếp patients.26 Mỗi loại ống đỡ động mạch dẫn đến một cải thiện đáng kể chứng khó nuốt | 294 Chapter 15 Figure 15-5A. The covered esophageal Wallstent. Figure 15-5B. The covered covered esophageal Z-stent. For a full-color version see page CA-XII of the Color Atlas. Figure 15-6. Illustration of an esophageal Flamingo stent bridging a distal esophageal tumor. For a full-color version see page CA-XIII of the Color Atlas. Maintenance of Luminal Patency 295 Figure 15-7. Covered Dua stent with distal sleeve to prevent acid reflux into esophagus post-stent deployment. For a full-color version see page CA-XIII of the Color Atlas. which theoretically reduces the amount of acid reflux across the stent into the esophagus post stent deployment.25 A recent study compared the various makes of esophageal stents Ultraflex stent Z-stent and Flamingo Wallstent available in Europe for efficacy and safety in 100 consecutive patients.26 Each stent type resulted in a significant improvement in dysphagia and similar reintervention rates of 24 to 33 . There was no statistical difference in complication rates between the different stents but a trend of higher major complications of 1.5 to 2 times was seen with placement of the Z-stent. A smaller comparative study found Ultraflex stents to have lower procedure-related mortality and complication rates when compared to esophageal Wallstents.27 A recently developed self-expanding plastic stent Polyflex Rusch Duluth Ga has been shown to have similar success complication and re-intervention rates compared to historical numbers reported with SEMS.28 However data on self-expanding plastic stents are still very limited with no direct comparison to metal stents. Multiple series exist which examine patient outcomes using esophageal self-expanding metal stents to treat malignant dysphagia. Examining the larger studies in the literature technical deployment is successful in greater than 95 of cases. Dysphagia scores routinely improve in 75 to 95 of patients with dysphagia scores improving a mean of 2 in most studies using a 4 or 6 point .