Gastrointestinal Stent Uygulamaları: Tek merkez deneyimi

Year 2021, Volume: 12 Issue: 42, 5 - 9, 15.04.2021

Mustafa Zanyar Akkuzu Orhan Sezgin Fehmi Ates Osman Özdoğan Serkan Yaraş Ferzan Aydın Hatice Rızaoğlu Balcı Enver Üçbilek Engin Altintas

https://doi.org/10.17944/mkutfd.804229

Abstract

Giriş ve Amaç
Gastrointestinal (Gİ) stentler gastrointestinal kanaldaki malign veya benign darlıklarda ve akciğer kanseri gibi komşu organ maligniteleri ile ilişkili bası veya fistüllerde ya da operasyonlardan sonraki darlık veya kaçaklarda palyatif amaçla kullanılmaktadır. Biz kliniğimizde taktığımız Gİ stentlerin takılma nedenlerini ve seyrini değerlendirerek Gİ stentlerle ilgili klinik deneyimimizi paylaşmayı amaçladık.

Materyal ve Metod
2014-2019 yılları arasında kliniğimizde çeşitli nedenlerle Gİ stent takılan olgular çalışmaya dâhil edilmiştir. Retrospektif olarak stent takılma nedeni, stent çeşidi, komplikasyon olup olmaması, komplikasyonların yönetimi ve hastaların yaşam süreleri incelendi. Özellikle ileri evre kanserlerde stentlerin palyatif tedavide etkinliği ve yaşam süresine katkısı değerlendirildi.

Bulgular
Bu süreçte toplam 36 hastaya Gİ stent takılmıştı. Hastalarımızın 24 (%67)’ü erkek ve 12 (%33)’si kadındı. Erkeklerin yaş ortalaması 67±13,8, kadınların yaş ortalaması 45,6±11,5 idi. Malign sebeplerle stent takılanların; %44,5’i özofagus kanseri, %19,5’i mide kanseri, %16,6’sında akciğer kanseri ve %5,5’una da rektum kanseri nedeniyle stent takılmıştı. Benign nedenlerle stent takılanların %11,1’ine fistül, %2,8’ine de evre d özofajit nedeniyle stent takılmıştı. Hepsine SEMS takılmıştı. Hastalarımızın %27’si halen yaşamaktaydı. Hastalarımızın %73’ü ölmüş olup ortalama yaşam süresine baktığımızda 109,6±101 gün olarak saptadık.

Tartışma ve Sonuç
Sonuç olarak, ameliyat edilemeyen sindirim sistemi darlığı olan hastaların palyasyonunda stent kullanımının, mortalitesinin olmaması ve sınırlı morbiditesi ile kısa dönemde kaliteli bir palyasyon için etkin bir yöntem olduğu kanısındayız. Kendiliğinden genişleyen metal stentler kullanılarak malign ve benign disfajinin hafiflemesi sağlanabilir.

Keywords

Gastrointestinal stentler, Kendiliğinden genişleyen stentler, SEMS, Palyatif destek

Gastrointestinal Stent Applications: Single center experience

Abstract

Introduction and purpose
Gastrointestinal (GI) stents are used for palliative purposes in malignant or benign strictures in the gastrointestinal tract and pressure or fistulas associated with neighboring organ malignancies such as lung cancer, or stenosis or leakage after operations. We aimed to share our clinical experience with GI stents by evaluating the reasons and course of GI stents we used in our clinic.
Materials and Methods
Patients who had a GI stent in our clinic between 2014 and 2019 were included in the study. Retrospectively, the reason for stent insertion, the type of stent, the presence or absence of complications, the management of the complications and the life span of the patients were analyzed. Especially in advanced stage cancers, the effectiveness of stents in palliative treatment and their contribution to life span were evaluated.
Results
During this period, a total of 36 patients had GI stents implanted. 24 (67%) of our patients were male and 12 (33%) were female. The mean age of men was 67 ± 13.8, and the mean age of women was 45.6 ± 11.5. Those who are stented for malign reasons; A stent was implanted for 44.5% esophageal cancer, 19.5% stomach cancer, 16.6% lung cancer and 5.5% rectal cancer. Of those who were stented for benign reasons, 11.1% had a fistula, and 2.8% had a stent due to stage d esophagitis. SEMS was attached to all of them. 27% of our patients were still alive. 73% of our patients died and when we looked at the average life span, we found it as 109.6 ± 101 days.
Discussion and Conclusion
In conclusion, we believe that the use of stents in palliation of patients with inoperable digestive system stenosis is an effective method for a quality palliation in the short term, with no mortality and limited morbidity. By using self-expanding metal stents, malignant and benign dysphagia can be alleviated.

Keywords

Gastrointestinal stents, Self-expanding stents, SEMS, Palliative support

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