Вестник хирургии имени И.И. Грекова (Jan 2018)
STENTING OF THE OESOPHAGUS AND OESOPHAGEAL ANASTOMOSES IN THE CASE OF NEOPLASTIC STENOSIS
Abstract
The authors aimed to optimize the strategy and technology of regeneration of oesophagus patency and oesophageal anastomosis in a case of tumor stenosis. Results of endoscopic correction of neoplastic stenosis of the oesophagus were studied in 244 patients, the cases of oesophagocolic anastomosis - in 12 patients and outcomes of oesophagogastric - in 8, respectively. A protection of self-expandable stents is an effective method of regeneration of enteral feeding in patients with manifested dysphagia, which is specified by the growth of malignant tumor of the oesophagus or oesophageal anastomosis. A possibility of formation of broncho-esophageal communications limits the usage of silicone tubular and steel self-expandable stents with partial coating of a funnel by special indications: a disposition of proximal border of tumor stenosis less than 3 cm from esophageal - pharyngeal passage - for the first; a necessity of fast recovery of oesophagus patency in rigid stenosis and an impossible single-stage dilatation of constriction zone - for the second. An optimal device for oesophagus and anastomosis protection is a fiber-nitinol self-expandable stent with coating. The stents with antireflux valve should be used in the case of oesophagogastric passage lesions.
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