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Objective To evaluate the safety and therapeutic effect of covered expandable metallic stent placement combined with interventional chemotherapy in treating malignant esophago-tracheal fistulae. Methods A total of 60 patients with esophago-tracheal fistula were enrolled in this study. The patients were randomly divided into control group (n=28) and study group (n=32). Patients of the control group were treated with covered stent implantation only, while patients of the study group were treated with combination use of covered stent implantation and interventional chemotherapy. All the patients were followed up regularly, the short-term and long-term results were determined, and the effect rate, median survival time and complications were statistically analyzed. Results Among the 60 patients, successful obstruction of the fistula was obtained in 58 with a success rate of 96.7%. The median survival time of the 58 patients was 5.8 months. The median survival time of the control group and the study group was 3.6 months and 8.7 months respectively, the difference between the two groups was statistically significant (P<0.05). The one-month, 3-month and 6-month effect rates were 78.1%, 68.8% and 62.5% respectively. The incidence of esophageal stent re-stenosis in the study group was much lower than that in the control group. Conclusion The combination use of covered stent implantation and interventional chemotherapy can effectively improve the median survival time of patients with malignant esophago-tracheal fistula, and reduce the occurrence of stent-related complications. Therefore, covered expandable metallic stent placement combined with interventional chemotherapy is an effective and safe treatment for malignant esophago-tracheal fistulae.
RESUMO
Objective To observe relationship between the phlegm and adhesion molecule and further explore the functions of the phlegm in the metastatic potential of the tumors. Methods Examin the expression difference of ICAM-1,E-cad,MMP-9 of gastric cancer by enzyme linked immunosorbent assay between the phlegm-stamp type and non-phlegm-stamp type,then reducing phlegm by chinese medicine treatment and comparing theirs expression variation.Results The expressions of ICAM-1,E-cad, MMP-9 were obviouslv different between the phlegm group and non-phlegm group[(403.6±99.7)μg/L,(9.08±1.69)mg/L,(465.0±96.64)μg/L &(319.9±81.4)μg/L,(7.56±1.15)mg/L,(228.1±43.79)μg/L].After using xiao-tan-san-jie recipes,the expressions of ICAM-1 and E-cad of the phlegm group were obviously lower than before(P<0.05);the expression of MMP-9 was also falling down,but the difference was not significative.Conclusion There is a correlation between the phlegm and adhesion molecule, which could take action in tumor metastams by affecting adhesion molecule expression.