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内镜下滴注真空治疗（iEVT）——一种用于结直肠吻合口漏和肛周并发症的新型内镜概念。

Endoscopic vacuum therapy with instillation (iEVT) - a novel endoscopic concept for colorectal anastomotic leak and perianal complications.

作者信息

Bobkiewicz Adam, Krokowicz Lukasz, Banasiewicz Tomasz, Borejsza-Wysocki Maciej

机构信息

Department of General, Endocrinological and Gastroenterological Oncology Surgery, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):560-566. doi: 10.5114/wiitm.2020.93204. Epub 2020 Feb 24.

DOI:10.5114/wiitm.2020.93204
PMID:33294070
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7687668/
Abstract

INTRODUCTION

Anastomotic leaks remain the most fearful complications.

AIM

We present a novel endoscopic salvage therapy known as endoscopic vacuum therapy with instillation (iEVT) as a combination of standard endoscopic vacuum therapy (EVT) and negative pressure wound therapy with instillation (iNPWT).

MATERIAL AND METHODS

A case series of 6 consecutive patients treated with iEVT is presented. A Redon drain and a central venous catheter were introduced within polyurethane foam used as a self- made device for iEVT and antimicrobial solution was instilled.

RESULTS

A total of 6 patients with the mean age of 29.5 ±8.9 were treated with iEVT. The mean number of iEVT sessions was 5.8 ±2.3. The mean time of iEVT management was 20.7 ±8.8 days. Locally, a reduction in purulent discharge and defect's dimension with contraction were revealed confirmed with imaging studies.

CONCLUSIONS

iEVT is a very encouraging, novel method for complicated perianal diseases and anastomotic leak.

摘要

引言

吻合口漏仍然是最可怕的并发症。

目的

我们提出一种新型的内镜挽救治疗方法，即内镜滴注式真空治疗（iEVT），它是标准内镜真空治疗（EVT）和滴注式负压伤口治疗（iNPWT）的结合。

材料与方法

介绍了一组连续6例接受iEVT治疗的病例。在用作iEVT自制装置的聚氨酯泡沫内插入一根雷顿引流管和一根中心静脉导管，并滴注抗菌溶液。

结果

共有6例平均年龄为29.5±8.9岁的患者接受了iEVT治疗。iEVT治疗的平均次数为5.8±2.3次。iEVT治疗的平均时间为20.7±8.8天。在局部，影像学研究证实脓性分泌物减少，缺损尺寸缩小且有收缩。

结论

iEVT是一种用于复杂肛周疾病和吻合口漏的非常令人鼓舞的新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/74e16634cd08/WIITM-15-39954-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/dc98a4615f1e/WIITM-15-39954-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/201283c0cff4/WIITM-15-39954-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/dd79de219a83/WIITM-15-39954-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/74e16634cd08/WIITM-15-39954-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/dc98a4615f1e/WIITM-15-39954-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/201283c0cff4/WIITM-15-39954-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/dd79de219a83/WIITM-15-39954-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/144f/7687668/74e16634cd08/WIITM-15-39954-g004.jpg

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