荧光透视引导下球囊扩张术治疗近端小肠术后非吻合口狭窄：一项长达15年的单机构经验

Fluoroscopic Balloon Dilation for Treating Postoperative Nonanastomotic Strictures in the Proximal Small Bowel: A 15-Year Single-Institution Experience.

作者信息

Tsauo Jiaywei, Kim Kun Yung, Song Ho-Young, Park Jung-Hoon, Jun Eun Jung, Kim Min Tae, Yoon Sung-Hwan

机构信息

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.

出版信息

J Vasc Interv Radiol. 2017 Aug;28(8):1141-1146. doi: 10.1016/j.jvir.2017.01.003. Epub 2017 Mar 7.

DOI:10.1016/j.jvir.2017.01.003

PMID:28283402

Abstract

PURPOSE

To evaluate safety and effectiveness of fluoroscopic balloon dilation (FBD) for treating postoperative nonanastomotic strictures in proximal small bowel.

MATERIALS AND METHODS

Data of 44 patients (26 men and 18 women; mean age, 53.7 y ± 13.0) treated with FBD for postoperative nonanastomotic strictures in the proximal small bowel between January 2000 and February 2016 were retrospectively reviewed. Site of stricture was located in the first portion of duodenum in 8 (18.2%) patients, second portion of duodenum in 8 (18.2%) patients, third portion of duodenum in 1 (2.3%) patient, fourth portion of duodenum in 1 (2.3%) patient, and proximal jejunum in 26 (59.1%) patients. Mean distance between the most anal-side lesion and the oral cavity was 63.9 cm ± 15.0.

RESULTS

Technical success was achieved in 39 (88.6%) patients. Mean stricture length was 3.0 cm ± 1.8. Technical failure because of inability to negotiate the guide wire through the stricture occurred in 5 (13.6%) patients. Complete resolution of obstructive symptoms and resumption of oral intake of soft or solid food within 3 days occurred in 34 patients after 1 (n = 32) or 2 (n = 2) FBD sessions, rendering a clinical success rate of 87.2%. There were no major complications directly related to FBD. Median follow-up period was 1,406 days (interquartile range, 594-2,236 d). Nine (26.5%) patients had recurrence within a median 47 days (interquartile range, 20-212 d).

CONCLUSIONS

FBD may be safe and effective for treating postoperative nonanastomotic strictures in the proximal small bowel.

摘要

目的

评估透视下球囊扩张术（FBD）治疗近端小肠术后非吻合口狭窄的安全性和有效性。

材料与方法

回顾性分析2000年1月至2016年2月间44例接受FBD治疗近端小肠术后非吻合口狭窄患者（26例男性，18例女性；平均年龄53.7岁±13.0岁）的数据。狭窄部位位于十二指肠第一部8例（18.2%），十二指肠第二部8例（18.2%），十二指肠第三部1例（2.3%），十二指肠第四部1例（2.3%），空肠近端26例（59.1%）。最靠近肛门侧病变与口腔的平均距离为63.9 cm±15.0。

结果

39例（88.6%）患者技术成功。平均狭窄长度为3.0 cm±1.8。5例（13.6%）患者因导丝无法通过狭窄导致技术失败。接受1次（n = 32）或2次（n = 2）FBD治疗后，34例患者在3天内梗阻症状完全缓解并恢复软食或固体食物经口摄入，临床成功率为87.2%。无直接与FBD相关的严重并发症。中位随访期为1406天（四分位间距，594 - 2236天）。9例（26.5%）患者在中位47天（四分位间距，20 - 212天）内复发。