Covered stent in treatment of esophageal carcinoma and cardiac carcinoma strictures and fistula complication and curative effect analysis of 158 cases

Objective To explore the technique of correlative plantation in the prevention,treatment of complication and therapeutic effective of advanced esophageal and cardiac carcinoma stenosis and esophageal fistula by introducing the nickle_titanium alloy coated stent which is made in China.Methods The choice of the hospital in 158 cases of advanced esophageal and cardiac carcinoma and some with esophageal fistula in patients with esophageal endoscopy and X-ray machine,with covered stent in treatment of esophagus,observed in patients with postoperative complications and tumor treatment,and regular follow up.Results Among the 158 patients,we successfully implanted stent in 156 patients,The success rate was higher up to 98.7%.Swallowing obstruction were quickly relieved.Of 156 patients,the main complications are retroternal pain;fever;esophageal reflux;bleeding;stent slipping displacement;restnosis;and mediastinitis(or abscess).Stent combined with radiotherapy in 72 patients,near future curative effect for CR 48.6%,PR 34.7%,CR+PR=83.3%,SD 16.7%.During the follow up in 141cases,The survival time was 5-37 months,the median survival time(MST) was 11.5 months.69 patients had the stent without radiotherapy was 5-16 months,MST:9.6months;72 patients had stent with radiotherapy was 7-37 months,MST:15.6 months;the median survival time were significantly different(P0.01).Stent with radiotherapy:the survival rate of 1、2、3year are 54.2%,31.9%,13.9%.ConclusionsThe therapeutic effect of esophageal and gastric cardia carcinoma stenosis and esophageal fistula by introducing the coated stent was satisfactory,showing good biocompatibility,the relax rate of dysphagia is high.The implantation technique is the key to prevent and reduce the incidence of complication.Stent with radiotherapy curative effect is remarkable,can significantly prolong the survival time of the patient's had stent.