1996 年 47 巻 2 号 p. 160-165
Stents were endoscopically implanted in 74 patients with stenosis of the upper gastrointestinal tract associated with unresectable, malignant tumors. The rate of successful stent placement was 90.5%. The improvement in oral food intake was analyzed according to the location of stenosis in the 67 patients in whom stents could be placed. Among the patients with stenosis of the upper or middle esophagus, a total of 82.5% showed some improvement in oral food intake : 62.5% were able to ingest an all-rice-gruel diet, and 20.0% had improved oral food intake as compared with before.stent placement. Among the patients with stenosis of the lower esophagus or cardia, 84% had some improvement; 20% could ingest an all-rice-gruel diet; and 64% had better oral food intake than before stent placement. The majority of patients in this latter group could not ingest even an all-rice-gruel diet, indicating that improved stents are necessary. We have designed and clinically employed a curved prosthesis equipped with a valve to prevent reflux. Our initial clinical experience indicates that this stent is useful in preventing reflux.
Recently, self-expandable metal stents have been developed, and they are now used clinically. These newer stents are easier to implant, lighter, and more resistant to displacement than conventional stents. Self-expandable stents can be expected to become more popular in the future.
