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内镜扩张联合平阳霉素注射治疗直肠手术后良性吻合口狭窄的临床疗效。

Clinical efficacy of endoscopic dilation combined with bleomycin injection for benign anastomotic stricture after rectal surgery.

机构信息

Gastroenterology Department, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, China.

Digestive Endoscopy Department & General Surgery Department, the First Affiliated Hospital with Nanjing Medical University & Jiangsu Province Hospital, Nanjing, China.

出版信息

Medicine (Baltimore). 2022 Aug 19;101(33):e30036. doi: 10.1097/MD.0000000000030036.

Abstract

Benign anastomotic stricture is a frequent complication after rectal surgery. This study investigated the feasibility of endoscopic dilation combined with bleomycin injection for benign anastomotic stricture after rectal surgery. 31 patients who diagnosed with benign anastomotic stricture after rectal surgery were included in this study. 15 patients received simple endoscopic dilation (dilation group) and 16 patients received endoscopic dilation combined with bleomycin injection (bleomycin group). The clinical effect and adverse events were compared in the 2 groups. The strictures were managed successfully and the obstruction symptoms were relieved immediately. There were 2 minor complications in dilation group and 3 minor complications in bleomycin group. The difference was not significant between the 2 groups (P > .05). During the follow-up, the mean reintervention interval was 4.97 ± 1.00 months in dilation group and 7.60 ± 1.36 months in bleomycin group. The median treatment times was 4 (range 3-5) in dilation group and 2 (range 2-3) in bleomycin group. The differences in the 2 groups were significant (P < .05). Compared with endoscopic dilation, endoscopic dilation combined with bleomycin injection may reduce the treatment times and prolong the reintervention interval, which is a safe and effective endoscopic management for benign anastomotic stricture after rectal surgery.

摘要

良性吻合口狭窄是直肠手术后的常见并发症。本研究探讨了内镜扩张联合平阳霉素注射治疗直肠手术后良性吻合口狭窄的可行性。 31 例直肠手术后诊断为良性吻合口狭窄的患者纳入本研究。 15 例患者接受单纯内镜扩张(扩张组),16 例患者接受内镜扩张联合平阳霉素注射(平阳霉素组)。比较两组患者的临床疗效和不良反应。两组狭窄均成功处理,梗阻症状立即缓解。扩张组有 2 例轻微并发症,平阳霉素组有 3 例轻微并发症。两组差异无统计学意义(P >.05)。随访期间,扩张组的平均再干预间隔为 4.97±1.00 个月,平阳霉素组为 7.60±1.36 个月。扩张组的中位治疗次数为 4(范围 3-5)次,平阳霉素组为 2(范围 2-3)次。两组差异有统计学意义(P<.05)。与内镜扩张相比,内镜扩张联合平阳霉素注射可能减少治疗次数,延长再干预间隔,是一种安全有效的内镜治疗直肠手术后良性吻合口狭窄的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d3c/9387986/61ef0f223c5d/medi-101-e30036-g001.jpg

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