自膨式金属支架治疗结直肠癌切除术后吻合口狭窄和漏
Treatment of anastomotic stenosis and leakage after colorectal resection for cancer with self-expandable metal stents.
作者信息
Lamazza Antonietta, Fiori Enrico, Schillaci Alberto, Sterpetti Antonio V, Lezoche Emanuele
机构信息
Department "Pietro Valdoni", Department "Paride Stefanini", Sapienza University of Rome, Rome, Italy.
Department "Pietro Valdoni", Department "Paride Stefanini", Sapienza University of Rome, Rome, Italy.
出版信息
Am J Surg. 2014 Sep;208(3):465-9. doi: 10.1016/j.amjsurg.2013.09.032. Epub 2014 Jan 17.
BACKGROUND
Self-expandable metallic stents can be used to treat patients with symptomatic anastomotic complications after colorectal resection.
METHODS
Twenty patients with symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of a self-expandable metal stent. Ten patients had "simple" anastomotic stricture. In the remaining 10 patients, a leak was associated with the stricture.
RESULTS
The anastomotic leakage healed without evidence of residual stricture or major fecal incontinence in 8 of 10 patients. Overall, the anastomotic stricture was resolved in 14 of the 20 patients.
CONCLUSIONS
Self-expandable metal stents represent a valid adjunctive to treat patients with symptomatic anastomotic complications after colorectal resection for cancer. They have a complementary role to balloon dilatation in case of simple anastomotic stricture, and they improve the rate of healing when the stricture is associated with a leak.
背景
自膨式金属支架可用于治疗结直肠切除术后出现症状性吻合口并发症的患者。
方法
20例结直肠切除术后出现症状性吻合口狭窄的患者接受了内镜下自膨式金属支架置入治疗。10例患者为“单纯性”吻合口狭窄。其余10例患者的狭窄伴有渗漏。
结果
10例患者中有8例吻合口漏愈合，无残余狭窄或严重大便失禁的迹象。总体而言，20例患者中有14例吻合口狭窄得到缓解。
结论
自膨式金属支架是治疗结直肠癌切除术后出现症状性吻合口并发症患者的有效辅助手段。对于单纯性吻合口狭窄，它们在球囊扩张方面具有互补作用，并且当狭窄伴有渗漏时可提高愈合率。
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