Departement Pietro Valdoni-Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, Rome 00167, Italy.
Surg Endosc. 2013 Mar;27(3):1045-8. doi: 10.1007/s00464-012-2522-y. Epub 2012 Oct 9.
Self-expanding metallic stent (SEMS) placement is a valid form of therapy for patients with obstructing colon rectal cancer. The procedure is not feasible for a minority of patients with a very low risk of bowel perforation. This report analyzes the results of a technical detail used for SEMS placement.
In 43 patients with colon rectal obstruction, the SEMS apparatus was introduced through a guidewire passed above the obstruction in the channel of a pediatric nasogastroscope (diameter, 4.9 mm). The pediatric nasogastroscope was passed into the obstruction and above, allowing the anatomy of the colorectal lesion and the passage of the guidewire to be visualized directly.
The SEMS was inserted successfully in all cases without complications. In a previous series of 82 patients who had passage of the guidewire through the obstruction blindly, four technical failures occurred (nonsignificant difference).
A pediatric nasogastroscope can be useful for passing the colon rectal obstruction and guiding the passage of the guidewire under direct vision.
自膨式金属支架（SEMS）放置术是治疗结直肠恶性梗阻的有效方法。但对于穿孔风险极低的少数患者，该方法并不可行。本研究分析了一种用于 SEMS 放置的技术细节的结果。
在 43 例结直肠梗阻患者中，通过导丝在通道内穿过梗阻部位将 SEMS 装置引入小儿胃镜（直径 4.9mm）。将小儿胃镜穿过梗阻部位并进入上方，可直接观察结直肠病变的解剖结构和导丝的通过情况。
所有病例均成功插入 SEMS，无并发症发生。在之前 82 例通过盲穿导丝通过梗阻的患者中，有 4 例出现技术失败（无显著差异）。
小儿胃镜可用于通过结直肠梗阻，并在直视下引导导丝通过。
