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在70岁以上患者中使用介入放射学在梗阻性结直肠癌中植入新型肠内支架

Implantation of a new enteral stent in obstructive colorectal cancer using interventional radiology in patients over 70 years of age.

作者信息

Miłek Tomasz, Ciostek Piotr

机构信息

Department of General and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2015 Jul;10(2):155-60. doi: 10.5114/wiitm.2015.52266. Epub 2015 Jun 15.

Abstract

INTRODUCTION

Colorectal cancer is the second leading cause of death due to cancer in Poland. The traditional approach to treat patients included a surgical procedure. Irrespective of the surgical method being used, surgical treatment of malignant colorectal obstruction is associated with prolonged hospitalisation, and the postoperative mortality rate is approximately 5-11%. Due to these problems, more interest has been shown in less invasive methods. Prosthesis implantation is a leading endoscopic method used currently in palliative or preoperative treatment.

AIM

To compare the results of implantation of traditional stents with the results of implantation of an own stent using minimally invasive methods.

MATERIAL AND METHODS

Left-sided colon obstruction due to cancer was an indication for transplantation. All patients were aged over 70 years and had serious concomitant diseases. The control group included 50 patients with colorectal cancer who received traditional stents in the period 2009-2011. Our stent covers only the internal length of a tumour. It is not equipped with anti-migration flares. To minimize the risk of migration it has a system of hooks that are responsible for permanent anchorage of the stent within the tumour mass.

RESULTS

Implantation technical and clinical success defined as effective decompression of intestinal obstruction was 100% in both groups. There were 2 cases of stent migration in the control group.

CONCLUSIONS

It is possible to achieve a secure surgical anastomosis after intestinal decompression. Stent implantation is fast and safe thanks to the positioning system that was used. The use of labelled hooks is a secure anti-migration solution.

摘要

引言

在波兰,结直肠癌是癌症相关死亡的第二大主要原因。治疗患者的传统方法包括外科手术。无论采用何种手术方法,恶性结直肠梗阻的手术治疗都伴随着住院时间延长,术后死亡率约为5 - 11%。由于这些问题,人们对侵入性较小的方法表现出了更多兴趣。假体植入是目前用于姑息治疗或术前治疗的主要内镜方法。

目的

比较传统支架植入结果与使用微创方法植入自制支架的结果。

材料与方法

因癌症导致的左侧结肠梗阻是移植的指征。所有患者年龄均超过70岁且伴有严重的合并症。对照组包括50例在2009 - 2011年期间接受传统支架的结直肠癌患者。我们的支架仅覆盖肿瘤的内部长度。它没有配备防迁移翼片。为了将迁移风险降至最低,它有一个钩子系统,负责将支架永久固定在肿瘤块内。

结果

两组中定义为肠梗阻有效减压的植入技术和临床成功率均为100%。对照组有2例支架迁移。

结论

肠道减压后实现安全的手术吻合是可能的。由于使用了定位系统,支架植入快速且安全。使用带标记的钩子是一种可靠的防迁移解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc4f/4520849/cf391b6a2ecf/WIITM-10-25275-g001.jpg

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