Bayrak Savas, Tatar Cihad, Kinaci Erdem, Cakar Ekrem, Colak Sukru, Sevinc Mert Mahsuni, Bektas Hasan
Department of General Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Department of General Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2019 Jan;14(1):46-51. doi: 10.5114/wiitm.2018.76072. Epub 2018 May 30.
Stent treatment can be applied to avoid surgery in surgically risky patients or to turn a high-risk emergency operation into a lower-risk elective operation and save time.
In this study, the techniques, clinical efficacy, safety and complications of endoscopic stents applied in emergency conditions were evaluated in patients with acute mechanical intestinal obstruction (AMIO) due to colorectal cancer.
Between 2013 and 2015, 23 patients with an average age of 69.5 ±13.5 years who presented with AMIO and anastomosis stenosis secondarily to cancer to the emergency department were subjected to stent treatment under emergency conditions.
Thirteen (56.5%) patients were diagnosed with colon cancer, 5 (21.7%) with rectal cancer, and 5 (21.7%) with stenosis in the previous anastomosis line. Fourteen (60.9%) patients were diagnosed with stage 4 cancer, 7 (30.4%) with stage 3 cancer and 2 (8.7%) with stage 2 cancer. The stents were applied to the sigmoid colon in 10 (43.5%) patients, to the recto-sigmoid area in 9 (39.1%) patients and to the rectum area in 4 (17.4%) patients. While 14 (60.9%) patients had local or locally advanced disease, 9 (39.1%) patients had metastases in different parts of their bodies, particularly in their livers.
The study demonstrates that stents offer a favorable therapeutic alternative to emergency surgery and are associated with promising short-term outcomes as well as an acceptable safety profile for AMIO.
支架治疗可用于避免对手术风险高的患者进行手术，或将高风险的急诊手术转变为低风险的择期手术并节省时间。
本研究评估了在因结直肠癌导致急性机械性肠梗阻（AMIO）的患者中，急诊条件下应用内镜支架的技术、临床疗效、安全性及并发症。
2013年至2015年期间，23例平均年龄为69.5±13.5岁、因AMIO及癌症继发吻合口狭窄而到急诊科就诊的患者在急诊条件下接受了支架治疗。
13例（56.5%）患者被诊断为结肠癌，5例（21.7%）为直肠癌，5例（21.7%）为既往吻合口处狭窄。14例（60.9%）患者被诊断为4期癌症，7例（30.4%）为3期癌症，2例（8.7%）为2期癌症。支架应用于乙状结肠的有10例（43.5%）患者，应用于直肠乙状结肠区域的有9例（39.1%）患者，应用于直肠区域的有4例（17.4%）患者。14例（60.9%）患者患有局部或局部晚期疾病，9例（39.1%）患者身体不同部位有转移，尤其是肝脏转移。
该研究表明，支架为急诊手术提供了一种良好的治疗选择，对于AMIO具有良好的短期疗效及可接受的安全性。
