Comparative Study On The Clinical Application Of Esophageal Stent Implantation Under Gastroscope And DSA Fluoroscopy In Advanced Esophageal Cancer

Objective: To explore the clinical application of esophageal stent placement under gastroscopy and digital subtraction angiography in patients with dysphagia of advanced esophageal cancer and the safety,effectiveness,success rate and complication rate of the two surgical methods were also compared and analyzed.Methods: The clinical data of 61 patients with advanced esophageal cancer who underwent esophageal stenting from September 2016 to October 2018 in Hechi Hospital Affiliated to Youjiang Medical College for Nationalities were retrospectively analyzed.Among them,29 cases underwent esophageal cancer stent implantation under direct gastroscopy and 32 cases underwent esophageal stent implantation under DSA fluoroscopy and the One-time success rate,clinical effect,swallowing degree before and after operation,length of operation,hospitalization time after operation,hospitalization cost and incidence of complications were analyzed and compared between the two groups.Results:(1).There was no significant difference in age,sex,location of esophageal neoplasm,length of stricture,distance from the upper edge of the neoplasm to the incisor teeth,pathological classification,staging and degree of dysphagia between the two groups(P > 0.05).(2).The success rate of esophageal stent implantation in both groups was 100%.There was no death in the two groups.There was no significant difference in clinical effect between the two groups(P = 0.773).(3).There was no significant difference in the improvement of dysphagia between the two groups after operation(P=0.796).There were significant differences in the degree of dysphagia before operation and the symptoms of dysphagia after operation(P<0.05).(4).The mean operation time under gastroscopy was 37.4 ±14.03 min)and under DSA fluoroscopy was 45.3±17.2 min).There was significant difference between the two groups(P=0.01).(5).There was no significant difference in hospitalization time between the two groups(P<0.05).(6).There was significant difference in hospitalization expenses between the two groups(P<0.05).(7).Comparisons of postoperative complications between the two groups: hemorrhage(blood in sputum)had statistical significance(P < 0.05),chest pain,restenosis,and stent displacement had no significant difference(P > 0.05).Conclusion :(1)Both gastroscopy and DSA esophageal stent implantation can effectively solve the symptoms of dysphagia in patients with advanced esophageal cancer.Both implantation methods are safe and effective,and the success rates of both operations are relatively high.(2)The operation time of gastroscopy group was shorter than that of DSA group,and the average hospitalization cost was lower than that of DSA group,but it was easy to bleed,and the bleeding situation was relatively slight,safe and controllable.(3).Gastroscopy has the advantages of treating bleeding,perforation and stent displacement during operation,without radiation risk,relatively low cost,and no expensive equipment.Esophageal stent implantation under gastroscope is more suitable for popularization in grass-roots hospitals.