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小儿患者的磁性胃肠吻合术。

Magnetic gastrointestinal anastomosis in pediatric patients.

作者信息

Zaritzky Mario, Ben Ricardo, Johnston Krystal

机构信息

Department of Radiology, The University of Chicago Medicine, Comer Children's Hospital, 5721S. Maryland Avenue, Chicago, IL 60637, USA.

Department of Gastroenterology, Hospital de Niños de La Plata, Calle 14 Nro 1631, La Plata, Buenos Aires, Argentina.

出版信息

J Pediatr Surg. 2014 Jul;49(7):1131-7. doi: 10.1016/j.jpedsurg.2013.11.002. Epub 2013 Nov 7.

Abstract

BACKGROUND/PURPOSE: To describe 17 patients who underwent magnetic, non-surgical gastrointestinal (GI) anastomoses.

METHODS

Patients with GI obstruction, stenosis, or atresia were treated with image-guided and/or endoscopically placed discoid magnet pairs or catheter-based bullet-shaped magnet pairs.

RESULTS

Anastomosis was achieved in 7 days in an 11-year-old with gastric outlet obstruction due to metastatic colon cancer. Anastomosis was achieved in 8 and 10 days in 2 patients (age 2.0 years and 3.4 years) who had rectocolonic stenosis. Re-anastomosis was achieved in an average of 6 days (range 3 to 7 days) in 5 patients (age 6 months to 5.9 years) with severe recurrent postsurgical esophageal stenosis refractory to dilatation. Primary esophageal anastomosis was achieved in an average of 4.2 days (range 3 to 6 days) in 9 patients with esophageal atresia (Type A or Type C surgically converted to Type A) with a gap length of 4 cm or less. The average age of these esophageal atresia patients was 3 months (range 23 days to 5 months).

CONCLUSION

Minimally invasive magnet placement was feasible and achieved anastomosis in all patients.

摘要

背景/目的:描述17例接受非手术性磁性胃肠吻合术的患者。

方法

对患有胃肠道梗阻、狭窄或闭锁的患者,采用影像引导和/或内镜放置盘状磁体对或基于导管的子弹形磁体对进行治疗。

结果

一名因转移性结肠癌导致胃出口梗阻的11岁患者在7天内实现吻合。两名患有直肠结肠狭窄的患者(年龄分别为2.0岁和3.4岁)分别在8天和10天实现吻合。5例(年龄6个月至5.9岁)严重复发性术后食管狭窄且扩张治疗无效的患者平均在6天(范围3至7天)内实现再次吻合。9例食管闭锁(A型或手术转为A型的C型)且间隙长度为4 cm或更短的患者平均在4.2天(范围3至6天)内实现一期食管吻合。这些食管闭锁患者的平均年龄为3个月(范围23天至5个月)。

结论

微创磁体放置是可行的,且所有患者均实现了吻合。

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