Köneş Osman, Kartal Abdulcabbar, Akarsu Murat, Akarsu Cevher, Güneş Mehmet Emin, Alış Halil
Sağlık Bilimleri University, Bakırköy Dr Sadi Konuk Educating and Training Hospital, General Surgery Clinic.
Okan University Hospital, General Surgery Department, İçmeler mah, Turkey.
JSLS. 2019 Jan-Mar;23(1). doi: 10.4293/JSLS.2018.00088.
Colonic stenting in left-sided tumor is being commonly used. However, placing a stent in the flexure tumors is rare because it is technically more difficult. In this study, we aimed to retrospectively screen patients with flexure tumors admitted to our clinic who were treated using a colonic stent and discuss our findings.
Patients admitted to the emergency department for obstructive colonic tumors between 2012 and 2017 were retrospectively evaluated, and 21 patients treated using stents were included in the study. The expandable metal stent (Wallflex®, Boston Scientific, Marlborough, MA, USA) was placed at the obstruction through the lead wire.
The mean age of the patients was 62 years, and the ratio of females to males was 3:18. Splenic flexure tumors were detected in 18 patients and hepatic flexure tumors in 3 patients. Seven of the patients were stented for palliative purposes. Fourteen of the cases underwent surgery. Three of them underwent laparoscopic surgery and eleven underwent open surgery.
Preoperative stenting in colonic flexura tumors is associated with faster healing, less postoperative complications, lower rates of colostomy, and higher rates of minimally invasive surgery, and can be safely used at experienced centers.
左侧肿瘤的结肠支架置入术已被广泛应用。然而，在结肠弯曲部肿瘤中放置支架的情况较为罕见，因为技术上更具难度。在本研究中，我们旨在回顾性筛选我院收治的接受结肠支架治疗的结肠弯曲部肿瘤患者，并讨论我们的研究结果。
对2012年至2017年间因结肠梗阻性肿瘤入住急诊科的患者进行回顾性评估，纳入21例接受支架治疗的患者。通过导丝将可扩张金属支架（Wallflex®，美国波士顿科学公司，马尔伯勒，马萨诸塞州）放置在梗阻部位。
患者的平均年龄为62岁，女性与男性的比例为3:18。18例患者检测出脾曲肿瘤，3例患者检测出肝曲肿瘤。7例患者接受支架置入术以缓解症状。14例患者接受了手术。其中3例接受了腹腔镜手术，11例接受了开放手术。
结肠弯曲部肿瘤的术前支架置入术可促进更快愈合，减少术后并发症，降低结肠造口术发生率，并提高微创手术率，在经验丰富的中心可安全使用。
