García-Cano J
Gastroenterology Service, Hospital Virgen de la Luz, Cuenca, Spain.
Dig Dis Sci. 2006 Jul;51(7):1231-5. doi: 10.1007/s10620-006-8040-9.
Self-expanding metallic stents are useful in relieving tumoral obstruction in the gastrointestinal tract. Endoscopic insertion is usually made through the working channel of a therapeutic endoscope. Fluoroscopy during insertion is thought to be mandatory in most cases. Endoscopists sometimes encounter problems in using or accessing fluoroscopy facilities. This study describes a method to insert, under certain circumstances, enteral Wallstents using only endoscopic control. An ultrathin gastroscope is used to pass severe tumoral strictures and place a guide wire beyond the stenosis. The ultrathin gastroscope is removed leaving the guide wire in place, which is then inserted in a retrograde fashion into a therapeutic colonoscope, allowing insertion of through-the-scope stents. Successful insertion was achieved in 5 malignant gastric outlet obstructions and in 6 rectosigmoid tumoral obstructions. In conclusion, in some cases using an ultrathin endoscope to place a guide wire beyond the stricture can be useful for endoscopic placement of Wallstents without fluoroscopy.
自膨式金属支架在缓解胃肠道肿瘤梗阻方面很有用。内镜插入通常通过治疗性内镜的工作通道进行。在大多数情况下，插入过程中进行荧光透视被认为是必需的。内镜医师在使用或使用荧光透视设备时有时会遇到问题。本研究描述了一种在某些情况下仅使用内镜控制插入肠道Wallstent支架的方法。使用超薄胃镜通过严重的肿瘤狭窄并将导丝置于狭窄部位之外。移除超薄胃镜，将导丝留在原位，然后以逆行方式插入治疗性结肠镜，从而允许插入经内镜支架。5例恶性胃出口梗阻和6例直肠乙状结肠肿瘤梗阻成功插入。总之，在某些情况下，使用超薄内镜将导丝置于狭窄部位之外可有助于在无荧光透视的情况下进行Wallstent支架的内镜放置。
