Осложнения эндоскопической имплантации пищеводных стентов

Обложка
  • Авторы: Иванов А.И.1,2,3, Попов В.А.4, Бурмистров М.В.5,3,4
  • Учреждения:
    1. Республиканский клинический онкологический диспансер
    2. Институт фундаментальной медицины и биологии Казанского федерального университета
    3. Казанская государственная медицинская академия — филиал Российской медицинской академии последипломного образования
    4. Республиканская клиническая больница
    5. Институт фундаментальной медицины и биологии Казанского федерального университета
  • Выпуск: Том 102, № 1 (2021)
  • Страницы: 74-84
  • Тип: Обзоры
  • Статья получена: 04.12.2020
  • Статья одобрена: 25.01.2021
  • Статья опубликована: 10.02.2021
  • URL: https://kazanmedjournal.ru/kazanmedj/article/view/52977
  • DOI: https://doi.org/10.17816/KMJ2021-74
  • ID: 52977


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Аннотация

Эндоскопическая имплантация пищеводных стентов служит эффективным методом устранения дисфагии при злокачественных стенозах пищевода. Однако данная технология сопряжена с риском возникновения множества осложнений, в том числе и фатальных для жизни. Среди них встречаются кровотечения, рестеноз, фрагментация и разрушение стента, миграция стента, пневмомедиастинум, формирование пищеводных свищей, перфорации, обструкция стента пищевыми массами, ретростернальные боли, гастроэзофагеальные рефлюксные изменения, сдавление дыхательных путей, аспирационная пневмония и лихорадка. Частота осложнений составляет 36–40%, смертность, связанная со стентированием, — от 3,9 до 27,2%. Тем не менее, на сегодняшний день существуют пути минимизации частоты осложнений благодаря постоянному прогрессу эндоскопических технологий и усовершенствованию конструкций современных стентов. Кроме того, в большинстве случаев эндоскопические интервенции позволяют эффективно справляться с подавляющим большинством осложнений после имплантации стентов при условии их своевременного выявления. Для достижения высокой эффективности стентирования крайне важно обеспечить профилактику осложнений путём оптимального выбора пищеводного стента и тщательного отбора пациентов с низким риском развития осложнений, связанных с имплантацией стента. Оценка факторов риска возможных осложнений, конструкции стентов и их характеристик, а также применение современных методов эффективного разрешения возможных осложнений позволяет улучшить качество и увеличить продолжительность жизни у инкурабельных больных раком пищевода. В обзоре отражены возможные осложнения стентирования пищевода и пищеводно-желудочного перехода, факторы, влияющие на возникновение осложнений, а также современные и эффективные методы их коррекции и профилактики.

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Алексей Игоревич Иванов

Республиканский клинический онкологический диспансер; Институт фундаментальной медицины и биологии Казанского федерального университета; Казанская государственная медицинская академия — филиал Российской медицинской академии последипломного образования

Email: a.i.ivanov@inbox.ru
ORCID iD: 0000-0002-2554-2223
Россия, г. Казань, Россия; г. Казань, Россия; г. Казань, Россия

Владимир Альбертович Попов

Республиканская клиническая больница

Автор, ответственный за переписку.
Email: lyapac@mail.ru
ORCID iD: 0000-0003-0998-4547
Россия, г. Казань, Россия

Михаил Владимирович Бурмистров

Институт фундаментальной медицины и биологии Казанского
федерального университета; Казанская государственная медицинская академия — филиал Российской медицинской академии последипломного образования; Республиканская клиническая больница

Email: burma71@mail.ru
ORCID iD: 0000-0002-5334-6481
Scopus Author ID: 8295829500
ResearcherId: Z-1667-2018
Россия, г. Казань, Россия; г. Казань, Россия; г. Казань, Россия

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