Berselli Mattia, Borroni Giacomo, Livraghi Lorenzo, Quintodei Valeria, Sambucci Daniele, Cortelezzi Claudio, Segato Sergio, Carcano Giulio, Cocozza Eugenio
Department of Surgery, Surgical Oncology and Minimally Invasive Division.
Department of Specialist Medicine, Gastroenterology Division, ASST Settelaghi.
Surg Laparosc Endosc Percutan Tech. 2019 Apr;29(2):133-137. doi: 10.1097/SLE.0000000000000623.
Endoscopic self-expandable metal stent (SEMS) placement as a bridge to surgery in large bowel neoplastic obstruction is an alternative to emergency surgery for the obstructive colorectal neoplasms. This study aims to analyze postoperative and long-term outcomes in a series of patients who underwent laparoscopic colorectal resection after SEMS placement. The analysis, after the stratification based on the time elapsed between the onset of the occlusive symptoms and the SEMS positioning, revealed an interesting result, with lower mortality for patients who underwent the procedure within 24 hours of hospitalization (P=0.0159). This trend may indicate the need to reduce the endoscopic time schedules as much as possible, even if an emergency procedure is needed. The laparoscopic approach, after stent placement as bridge therapy, can be a safe alternative to emergency surgery, if the procedure is precociously applied.
内镜下自膨式金属支架（SEMS）置入作为大肠肿瘤性梗阻手术的桥梁，是梗阻性结直肠肿瘤急诊手术的一种替代方案。本研究旨在分析一系列在SEMS置入后接受腹腔镜结直肠切除术患者的术后及长期结局。基于闭塞症状出现与SEMS定位之间的时间进行分层分析后，得出了一个有趣的结果，即住院24小时内接受该手术的患者死亡率较低（P = 0.0159）。这一趋势可能表明，即使需要进行急诊手术，也应尽可能缩短内镜检查时间安排。如果能尽早采用该手术，在支架置入作为桥接治疗后采用腹腔镜手术方法，可以作为急诊手术的一种安全替代方案。
