Ponte Ana, Pinho Rolando, Proença Luísa, Silva Joana, Rodrigues Jaime, Sousa Mafalda, Silva João Carlos, Carvalho João
Ana Ponte, Rolando Pinho, Luísa Proença, Joana Silva, Jaime Rodrigues, Mafalda Sousa, João Carlos Silva, João Carvalho, Department of Gastroenterology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, 4434-502 Porto, Portugal.
World J Gastrointest Endosc. 2017 Jun 16;9(6):267-272. doi: 10.4253/wjge.v9.i6.267.
To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications.
Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described. The technical success, corresponding to proper placement of the stent in the stomach resulting in exclusion of the SG leak or the stenosis, was evaluated. Complications related to stenting were also reported.
Five procedures were included to treat 2 staple line leaks and 3 stenoses. Two types of stents were used, including a fully covered self-expandable metal stent designed for the SG anatomy (Hanarostent, ECBB-30-240-090; M.I. Tech, Co., Ltd, Seoul, South Korea) in 4 procedures and a biodegradable stent (BD stent 019-10A-25/20/25-080, SX-ELLA, Hradec Kralove, Czech Republic) in the remaining procedure. In all cases, an overtube was advanced with the endoscope through the SG to the duodenum. After placement of the guidewire and removal of the endoscope, the stent was easily advanced through the overtube. The overtube was pulled back and the stent was successfully deployed under fluoroscopic guidance. Technical success was achieved in all patients.
The adoption of a modified technique of deployment of OTW stents using an overtube may represent an effective option in the approach of SG complications.
描述一种改良技术，即使用专为袖状胃切除术后（SG）并发症的气囊辅助肠镜检查开发的外套管来部署支架。
回顾性收集2010年1月至2015年12月期间所有接受内镜支架置入术治疗SG狭窄或渗漏的患者。描述了使用气囊外套管辅助改良的经钢丝（OTW）支架置入技术为患者进行的手术。评估技术成功率，即支架在胃内正确放置，从而排除SG渗漏或狭窄。还报告了与支架置入相关的并发症。
纳入5例手术，治疗2例吻合口漏和3例狭窄。使用了两种类型的支架，包括4例手术中使用的专为SG解剖结构设计的全覆膜自膨式金属支架（Hanarostent，ECBB - 30 - 240 - 090；韩国首尔M.I. Tech有限公司），以及其余1例手术中使用的可生物降解支架（BD支架019 - 10A - 25/20/25 - 080，SX - ELLA，捷克共和国赫拉德茨克拉洛韦）。在所有病例中，外套管与内镜一起通过SG推进至十二指肠。放置导丝并移除内镜后，支架很容易通过外套管推进。将外套管撤回，在荧光透视引导下成功部署支架。所有患者均取得技术成功。
采用使用外套管的改良OTW支架部署技术可能是处理SG并发症的一种有效选择。
