Palliative Treatment With Self-expandong Metallic Stent Imlplantation In Malignant Esophageal Strictures

The oesophageal carcinoma is a kind of malignant tumor which does great harm to people' health . Our country is also one of the countries which have the highest death rate due to the oesophageal carcinoma.The occoruance of oesophageal carcinoma has obvious difference in the geography distribution. The oesophageal carcinoma can be treated by surgical and non-surgical therapy and the surgical therapy is regarded as the first choice . But most of pations had missed the chance to excise the tumor when they went to the docter. The gradual difficulty of deglutition and the consuming of the tumor make the pations prostrate immediately. In my research , we implanted the self-expanding metallic stent in the pations in order treat the malignant oesophageal strictures.We choosed 35 pations who were treated in the guangdong province hospital from 2001.9 to 2004.4. All the pations were diagnosed the malignant oesophageal strictures with sever difficulty of deglutition by X-ray, oesophagoscope and pathology examination. We judged the position, length , iameter of the strictures accurately and choosed the appropriate stent. All the pations were forbidden to take in any food.We hocused the fauces of patients by lituocarine and tried to make the conduct thread move through the oesophageal stricture. The stent delivery instrument moved through the sricture by the guide wire and the self-expanding stent were released gently through the stricture. The end of the stent exceeded the range of the stricture 2 centimeteres. The patients took in a little lopromide and we can observed the expanding condition of the stent. All the stents were implanted into the esophagus succesfuly. The deglutition difficulty in 30 patients with pure malignant esophageal strictures were catabatic obviously from III-IV to I grade, the symptoms in other 5 patients with trachea fistula were also catabatic greatly.After the following persuit for 2-18 monthes, we found that all the stents were open and the oesophagus were through.The patients' nutrition condition were improved and the weight were increased. 25 patients survived for more than one year by the chemical and radiologic therapy. In conclusion, the implantion of self-expanding stent can improved the nutrition condition of the patients with in malignant esophageal strictures and protract their surviving time. Other treatment can be performed based on the implantion of self-expanding stent. The implantion of self-expanding stent is a effective palliative treatment to the the patient with malignant esophageal strictures.