Esophageal stent placement without optical or fluoroscopic visualization.
Esophageal stent placement without optical or fluoroscopic visualization.
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DOI：
10.1016/j.vgie.2017.07.013
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
White RE
中科院分区：
文献类型：
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作者：
Mwachiro MM;Parker RK;Chepkwony R;Burgert SL;White RE
食管癌是肯尼亚西南部农村Tenwek医院最常见的恶性肿瘤。肯尼亚西部一直处于食管鳞状细胞癌的地理高发区，2,3，但在非洲东部和南部有一个日益被认识到的风险走廊。4,5为了给这种难治性疾病提供有意义的缓解，Tenwek医院的医生已经开始放置自膨胀金属支架（SEMSs）。支架置入的总费用约为400美元，包括进口和手术相关费用。该程序在门诊基础上进行，平均持续时间为15分钟。该技术在低资源地区有很大的效用，没有获得透视，很容易复制。最近的报道表明，使用特制的支架，SEMSs可用于难治性静脉曲张出血；然而，我们没有这些适应症的经验。在其他基础设施有限和放化疗尚不容易获得的环境中，门诊SEMS放置单独测量可能以低成本提供有效的缓解。为了证明该方法的有效性和效率，我们描述了tenweek医院的一个典型病例（视频1，可在www上获得）。VideoGIE。org)。
Esophageal cancer is the most common malignancy presenting to Tenwek Hospital in rural southwestern Kenya. 1 Western Kenya has been within a geographic high-risk area for esophageal squamous cell carcinoma, 2, 3 but there is an increasingly recognized corridor of risk within eastern and southern Africa. 4, 5 To provide meaningful palliation for this difficult disease, physicians at Tenwek have begun placing self-expanding metal stents (SEMSs). 6 The overall cost of stent placement is approximately US $400, including import and procedure-related expenses. The procedure is performed on an outpatient basis and averages 15 minutes in duration. The technique has great utility in low-resource areas without access to fluoroscopy and is easily replicable.Recent reports have shown that SEMSs can be used for refractory variceal bleeding 7 with the use of a specially made stent; however, we do not have experience with those indications. In other settings with limited infrastructure and where chemoradiation is not yet readily accessible, outpatient SEMS placement with measurements alone may offer efficient palliation at low cost. To demonstrate the effectiveness and efficiency of the method, we describe a typical case at Tenwek Hospital (Video 1, available online at www. VideoGIE. org).