tailieunhanh - Carcinoma of the Esophagus - part 10

Các ống đỡ động mạch thực quản có sẵn cung cấp cho sự biện giải trong ung thư thực quản, nhưng nhu cầu cấp thiết nhất là cho một thiết bị tạm thời có thể được sử dụng ở những bệnh nhân đang được downstaged trước khi phẫu thuật | 140 T. Sabharwal and A. Adam Metallic stent insertion has a very low procedural mortality rate between 0 and 26 28 29 30 31 35 . Stent insertion in patients who have had recent radiotherapy or in whom radiotherapy is given immediately after the insertion of a stent is associated with an increased rate of complications particularly hemorrhage 38 39 64 65 66 67 . We recommend an interval of at least 4-6 weeks after radiotherapy and stent insertion. Conclusions The available esophageal stents provide palliation in esophageal cancer but the most urgent need is for a temporary device that can be used in patients who are being downstaged prior to surgery 68 without the need to use a removable stent which entails an additional procedure for the patient. Biodegradable devices would meet this need and some work is being undertaken to develop such stents. REFERENCES 1. P. C. Enzinger and R. J. Mayer. Medical progress Esophageal cancer. N Engl J Med 349 23 2003 2241-52. 2. P. Pisani D. M. Parkin F. Bray et al. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer 83 1999 18-29. 3. A. K. Kubba and N. Krasner. An update in the palliative management of malignant dysphagia. Eur J Surg Oncol 26 2000 116-29. 4. R. Mason. Palliation of oesophageal cancer. Surg Oncol 10 2001 123-6. 5. R. Morgan and A. Adam. Esophageal stents - An update. Semin Intervent Radiol 18 3 2001 251-64. 6. . Lee. The role of oesophageal stenting in the non-surgical management of oesophageal strictures. Br J Radiol 74 2001 891-900. 7. A. Adam J. Ellul A. F. Watkinson et al. Palliation of inoperable esophageal carcinoma a prospective randomised trial of laser therapy and stent placement. Radiology 202 1997 344-8. 8. A. M. Gevers E. Macken M. Hiele et al. A comparison of laser therapy plastic stents and expandable metal stents for palliation of malignant dysphagia in patients without a fistula. Gastrointest Endosc 48 1998 383-8. 9. D. S. Tan R. C. Mason A. Adam et al. Minimally .