{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T01:15:13Z","timestamp":1649207713267},"reference-count":32,"publisher":"Akademiai Kiado Zrt.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2009,4,1]]},"abstract":"<jats:title>Absztrakt<\/jats:title>\n        <jats:p>\n          <jats:italic>H\u00e1tt\u00e9r:<\/jats:italic> A nyel\u0151cs\u0151sz\u0171k\u00fcletet okoz\u00f3 daganat kiindul\u00e1si helye \u00e1ltal\u00e1ban maga a nyel\u0151cs\u0151, de okozhat stenosist a cardia, a t\u00fcd\u0151, a mediastinum tumora \u00e9s ritka esetekben mammatumor metastasisa is. Az ilyen esetek nagy r\u00e9sze inoper\u00e1bilis, \u00e1ltal\u00e1ban a betegs\u00e9g el\u0151rehaladott st\u00e1diuma, illetve a komorbidit\u00e1s \u00e9s az \u00e9letkor miatt. A betegek t\u00f6bbs\u00e9ge ez\u00e9rt csak palliat\u00edv ter\u00e1pi\u00e1ban r\u00e9szes\u00fclhet. A leg\u00e1ltal\u00e1nosabb \u00e9s az \u00e9letmin\u0151s\u00e9get legink\u00e1bb befoly\u00e1sol\u00f3 t\u00fcnet a dysphagia, melynek megold\u00e1s\u00e1ra t\u00f6bb lehet\u0151s\u00e9g is k\u00edn\u00e1lkozik. Dolgozatunkban az \u00f6nt\u00e1gul\u00f3 f\u00e9msztentekkel szerzett tapasztalatainkat foglaljuk \u00f6ssze. <jats:italic>Betegek \u00e9s m\u00f3dszerek:<\/jats:italic> 2003\u20132008 k\u00f6z\u00f6tt tumoros nyel\u00e9szavar\/-k\u00e9ptelens\u00e9g miatt oszt\u00e1lyunkon \u00f6sszesen 64 betegn\u00e9l (15 n\u0151 \/ 49 f\u00e9rfi) v\u00e9gezt\u00fcnk 68 endoscopos sztentbehelyez\u00e9st. Radiol\u00f3giai kivizsg\u00e1l\u00e1st k\u00f6vet\u0151en a tumor poz\u00edci\u00f3ja alapj\u00e1n distalisan nyit\u00f3d\u00f3 antireflux-billenty\u0171vel ell\u00e1tott vagy a n\u00e9lk\u00fcli fedett sztenteket alkalmaztunk, egy esetben proximalisan nyit\u00f3d\u00f3 fedett sztent ker\u00fclt behelyez\u00e9sre a tumor magas poz\u00edci\u00f3ja miatt. C\u00e9lunk a per os t\u00e1pl\u00e1lhat\u00f3s\u00e1g biztos\u00edt\u00e1sa, illetve az esetleges fistul\u00e1k fed\u00e9se volt. <jats:italic>Erdem\u00e9nyek:<\/jats:italic> A nyel\u00e9s minden esetben jelent\u0151sen javult. A dysphagia score a sztentbehelyez\u00e9s el\u0151tt \u00e1tlagosan 3,2 volt, m\u00edg a sztent behelyez\u00e9se ut\u00e1n 1,7-re cs\u00f6kkent. Fontos adat, hogy a fistul\u00e1k z\u00e1r\u00e1sa minden esetben eredm\u00e9nyes volt. A sztentek behelyez\u00e9se kapcs\u00e1n technikai probl\u00e9m\u00e1k alacsony ar\u00e1nyban (2\/68 \u2013 2,94%) ad\u00f3dtak. A beavatkoz\u00e1sokat k\u00f6vet\u0151en egy esetben \u00e9szlelt\u00fcnk 7 napon bel\u00fcl migrati\u00f3t. Egy betegn\u00e9l a beavatkoz\u00e1st k\u00f6vet\u0151en 2 nappal nem fat\u00e1lis myocardialis infarctus alakult ki. K\u00e9s\u0151i sz\u00f6v\u0151dm\u00e9nyk\u00e9nt tumorben\u00f6v\u00e9s, illetve t\u00faln\u00f6v\u00e9s \u00f6t alkalommal, v\u00e9rz\u00e9ses sz\u00f6v\u0151dm\u00e9ny \u00f6sszesen n\u00e9gy alkalommal jelentkezett. Fistulak\u00e9pz\u0151d\u00e9st h\u00e1rom esetben \u00e9szlelt\u00fcnk. H\u00e9t napon t\u00fali sztentmigratio k\u00e9t esetben k\u00f6vetkezett be. Resztentel\u00e9sre \u00f6sszesen n\u00e9gy esetben, falatelakad\u00e1s miatt ism\u00e9telt endoscopos beavatkoz\u00e1sra h\u00e1rom esetben ker\u00fclt sor. <jats:italic>K\u00f6vetkeztet\u00e9sek:<\/jats:italic> A dysphagia-\u00e9rt\u00e9kek javul\u00e1sa bizony\u00edtja, hogy a f\u00e9msztentek hat\u00e9konyan jav\u00edtj\u00e1k a betegek nyel\u00e9si funkci\u00f3j\u00e1t. Tapasztalataink alapj\u00e1n a sztentf\u00fcgg\u0151 sz\u00f6v\u0151dm\u00e9nyek \u00f6sszar\u00e1nya alacsony. V\u00e9lem\u00e9ny\u00fcnk szerint az \u00f6nt\u00e1gul\u00f3 f\u00e9msztentekkel v\u00e9gzett nyel\u0151cs\u0151-intubatio biztons\u00e1gosan \u00e9s eredm\u00e9nyesen alkalmazhat\u00f3 a malignus oesophagus obstructio palliat\u00edv ter\u00e1pi\u00e1j\u00e1ban.<\/jats:p>","DOI":"10.1556\/maseb.62.2009.2.2","type":"journal-article","created":{"date-parts":[[2009,4,23]],"date-time":"2009-04-23T01:12:51Z","timestamp":1240449171000},"page":"59-66","source":"Crossref","is-referenced-by-count":1,"title":["Malignus nyel\u0151cs\u0151-obstructio palliati\u00f3ja \u00f6nt\u00e1gul\u00f3 f\u00e9msztent behelyez\u00e9s\u00e9velr"],"prefix":"10.1556","volume":"62","author":[{"given":"Bal\u00e1zs","family":"Tolm\u00e1csi","sequence":"first","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e1lm\u00e1n","family":"R\u00e1bai","sequence":"additional","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tam\u00e1s","family":"Szamosi","sequence":"additional","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zs\u00f3fia","family":"Czegl\u00e9di","sequence":"additional","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tibor","family":"Gy\u00f6keres","sequence":"additional","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Zsigmond","sequence":"additional","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"Banai","sequence":"additional","affiliation":[{"name":"1 Gasztroenterol\u00f3giai Oszt\u00e1ly, HM \u00c1llami Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, 1062, Budapest, Podmaniczky u. 111."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"1","first-page":"24","article-title":"A nyel\u0151cs\u0151 distalis \u00e9s a gyomor proximalis r\u00e9sz\u00e9b\u0151l kiindul\u00f3 adenocarcinom\u00e1k megel\u0151z\u00e9s\u00e9nek lehet\u0151s\u00e9gei","volume":"6","author":"Souza RF","year":"2006","journal-title":"CA Cancer J Clinic"},{"key":"2","doi-asserted-by":"crossref","first-page":"2667","DOI":"10.1111\/j.1572-0241.2007.01565.x","article-title":"A randomized prospective comparison of self-expandable plastic stents and partially covered self-expandable metal stents in the palliation of malignant esophageal dysphagia","volume":"102","author":"Conio M","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"3","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1097\/01.mcg.0000180631.61819.4a","article-title":"Self-expanding metal stents versus plastic prostheses in the palliation of malignant dysphagia","volume":"39","author":"Eickhoff A","year":"2005","journal-title":"J Clin Gastroenterol"},{"key":"4","first-page":"385","article-title":"Inoper\u00e1bilis nyel\u0151cs\u0151tumor palli\u00e1ci\u00f3ja endoszk\u00f3pos intub\u00e1ci\u00f3val","volume":"47","author":"Palot\u00e1s A","year":"2003","journal-title":"Magy Onk"},{"key":"5","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/j.1572-0241.2007.01542.x","article-title":"New design esophageal stents for the palliation of dysphagia from esophageal or gastric cardia cancer: a randomized trial","volume":"103","author":"Verschuur ML","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"6","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1080\/02841850601129007","article-title":"Radiological evaluation of covered self-expandable metallic stents used for palliation in patients with malignant esophageal strictures","volume":"2","author":"Neyaz Z","year":"2007","journal-title":"Acta Radiol"},{"key":"7","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1046\/j.1442-2050.2001.00168.x","article-title":"Best palliation in esophageal cancer: surgery, stenting, radiation, or what? 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