Division of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Gastrointest Endosc. 2021 Jan;93(1):34-46. doi: 10.1016/j.gie.2020.06.057. Epub 2020 Jun 25.
Technologic advancements in the field of therapeutic endoscopy have led to the development of minimally invasive techniques to create GI anastomosis without requiring surgery. Examples of the potential clinical applications include bypassing malignant and benign gastric outlet obstruction, providing access to the pancreatobiliary tree in those who have undergone Roux-en-Y gastric bypass, and relieving pancreatobiliary symptoms in afferent loop syndrome. Endoscopic GI anastomosis is less invasive and less expensive than surgical approaches, result in improved outcomes, and therefore are more appealing to patients and providers. The aim of this review is to present the evolution of luminal endoscopic gastroenteric and enteroenteric anastomosis dating back to the first compression devices and to describe the clinical techniques being used today, such as magnets, natural orifice transluminal endoscopic surgery, and EUS-guided techniques. Through continued innovation, endoscopic interventions will rise to the forefront of the therapeutic arsenal available for patients requiring GI anastomosis.
治疗内镜领域的技术进步使得无需手术即可通过微创技术来创建 GI 吻合。潜在的临床应用示例包括绕过恶性和良性胃出口梗阻，为已经接受 Roux-en-Y 胃旁路手术的人提供通向胰胆管树的通道，以及缓解输入袢综合征的胰胆症状。与手术方法相比，内镜 GI 吻合术创伤更小，费用更低，结果更好，因此更受患者和提供者的欢迎。本综述的目的是介绍从最初的压缩设备开始的腔内内镜胃肠吻合术和肠肠吻合术的发展，并描述当今使用的临床技术，如磁铁、经自然腔道内镜手术和 EUS 引导技术。通过持续创新，内镜干预将成为需要 GI 吻合术的患者治疗武器库中的前沿技术。
