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[内镜下电切及球囊扩张治疗结直肠区域良性吻合口狭窄]

[Endoscopic therapy of benign anastomotic stenoses in the area of the colon and rectum by electro-incision and balloon dilatation].

作者信息

Truong S, Klosterhalfen B, Arlt G, Mückter H, Schumpelick V

机构信息

Chirurgische Klinik, Medizinische Fakultät, Rheinisch-Westfälische Technische Hochschule, Aachen.

出版信息

Langenbecks Arch Chir. 1992;377(5):271-5. doi: 10.1007/BF00189472.

Abstract

21 patients with a severe anastomotic stenosis in the colorectal region were treated with hydraulic balloon dilatation and endoscopic electro-incision. The severity of symptoms directly correlates with the extent of stenosis (degree I phi 13 mm, n = 12; degree II phi 7 mm, n = 6; degree III phi 4 mm, n = 3). All patients with a stenosis of degree I and II were symptom-free after the endoscopic therapy. In 2 of 3 cases the symptoms of stenosis of degree III could clinically be improved after the treatment. The average frequency of dilatation was 1.5 x, complications such as bleeding or perforation were not registered. Animal studies explain anastomotic stenosis through an increased submucosal formation of collagen fibers followed by formation of scars in the anastomosis. The efficiency of electro-incision and balloon dilatation is based on an increased diameter in the anastomotic region without increased formation of new collagen fibers.

摘要

21例结直肠区域严重吻合口狭窄患者接受了水囊扩张和内镜下电切治疗。症状的严重程度与狭窄程度直接相关(I度狭窄,直径>13mm,n = 12;II度狭窄,直径>7mm,n = 6;III度狭窄,直径>4mm,n = 3)。所有I度和II度狭窄患者在内镜治疗后均无症状。3例III度狭窄患者中有2例治疗后临床症状得到改善。扩张的平均次数为1.5次,未出现出血或穿孔等并发症。动物研究表明,吻合口狭窄是由于黏膜下胶原纤维形成增加,随后吻合口形成瘢痕所致。电切和球囊扩张的有效性基于吻合区域直径增加,而新胶原纤维形成未增加。

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