Rodrigues-Pinto Eduardo, Baron Todd H
a Gastroenterology Department , Centro Hospitalar São João , Porto , Portugal.
b Division of Gastroenterology and Hepatology , University of North Carolina , Chapel Hill , North Carolina , USA.
Expert Rev Med Devices. 2016 Sep;13(9):793-805. doi: 10.1080/17434440.2016.1222898. Epub 2016 Aug 22.
Endoscopic ultrasound guided translumenal drainage of pancreatic fluid collections (PFCs) has been widely practiced for over a decade, using conventional plastic and self-expandable metal stents. The use of such stents for transmural drainage is off-label and limited by the lack of lumen-to-lumen anchorage, which can lead to leakage, migration and tissue trauma.
Novel stent designs dedicated to applications of translumenal drainage have recently emerged and promise to make transmural drainage quicker, safer, and more effective. Achieving faster resolution of the fluid collection, decreasing adverse events, decreasing recurrence rates, and lowering costs are critical to advancing the endoscopic management of PFCs. Expert commentary: Our paper suggests that the AXIOS stent is an innovative therapeutic approach for PFC drainage with excellent efficacy, safety, and relatively few adverse outcomes. Preliminary reports appear promising and large multicenter prospective studies are needed in the future to further determine its safety and efficacy.
内镜超声引导下经腔引流胰腺液体积聚(PFCs)已广泛应用了十多年,使用的是传统塑料支架和自膨式金属支架。此类支架用于经壁引流属于超说明书使用,且受限于缺乏腔对腔的固定,这可能导致渗漏、移位和组织创伤。
专门用于经腔引流应用的新型支架设计最近出现,有望使经壁引流更快、更安全且更有效。更快地解决液体积聚、减少不良事件、降低复发率以及降低成本对于推进PFCs的内镜治疗至关重要。
我们的论文表明,AXIOS支架是一种用于PFC引流的创新治疗方法,具有出色的疗效、安全性和相对较少的不良后果。初步报告看起来很有前景,未来需要进行大型多中心前瞻性研究以进一步确定其安全性和疗效。