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[结肠支架在急诊手术中的放置]

[The placement of colonic stents in emergency surgery].

作者信息

Banchini Filippo, Celoni Maurizio, Scabini Matteo, Capelli Patrizio

机构信息

Chirurgia Generale Vascolare Toracica, Ospedale Guglielmo da Saliceto, Piacenza.

出版信息

Ann Ital Chir. 2007 Jul-Aug;78(4):291-4.

Abstract

INTRODUCTION

The treatment for malignant colonic obstruction usually consists in a diverting colostomy. The usefulness colorectal stent to resolve the occlusion is a new interesting application to prevent unnecessary operation.

METHODS

From September 1999 to June 2005 73 patent underwent the positioning of colorectal stent for colorectal cancer or extrinsic compression under double fluoroscopic and endoscopic control. In 35 patient the stent was inserted as palliative measure, and 38 underwent stent as bridge to surgery.

RESULTS

The placement of the stent was achieved in all patient, with 94% (69/73) of clinical success. Perforation occurred in two patient, one related to the guide wire and the other to balloon dilatation of the stent. Reobstruction occurred in 3 patient and migration in 9. The mortality after stent placement was 4.1% (3/73). We perform a colostomy or an ileostomy in 4 patient bridge to surgery and in 4 palliative, for a total of 8 stoma (10.95%).

CONCLUSION

The usefulness of colorectal stent can be consider an alternative to colostomy especially in unresectable patients.

摘要

引言

恶性结肠梗阻的治疗通常包括造口术。结直肠支架用于解决梗阻是一种新的有趣应用,可避免不必要的手术。

方法

1999年9月至2005年6月,73例患者在双荧光镜和内镜控制下接受了结直肠癌或外部压迫导致的结直肠支架置入术。35例患者将支架作为姑息性措施置入,38例患者将支架作为手术桥梁置入。

结果

所有患者均成功置入支架,临床成功率为94%(69/73)。2例患者发生穿孔,1例与导丝有关,另1例与支架球囊扩张有关。3例患者发生再梗阻,9例患者发生移位。支架置入后的死亡率为4.1%(3/73)。在4例作为手术桥梁的患者和4例姑息性患者中,我们进行了结肠造口术或回肠造口术,共8例造口(10.95%)。

结论

结直肠支架的应用可被视为造口术的替代方法,尤其是在不可切除的患者中。

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