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急性左侧恶性结肠梗阻:内镜支架置入术能发挥作用吗?

Acute left-sided malignant colonic obstruction: Is there a role for endoscopic stenting?

作者信息

Russo Salvatore, Conigliaro Rita, Coppini Francesca, Dell'Aquila Emanuela, Grande Giuseppe, Pigò Flavia, Mangiafico Santi, Lupo Marinella, Marocchi Margherita, Bertani Helga, Cocca Silvia

机构信息

Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy.

Gastroenterology and Digestive Endoscopy Unit, Azienda USL, IRCCs di Reggio Emilia, Reggio Emilia 42122, Italy.

出版信息

World J Clin Oncol. 2023 May 24;14(5):190-197. doi: 10.5306/wjco.v14.i5.190.

Abstract

The therapy of left-sided malignant colonic obstruction continues to be one of the largest problems in clinical practice. Numerous studies on colonic stenting for neoplastic colonic obstruction have been reported in the last decades. Thereby the role of self-expandable metal stents (SEMS) in the treatment of malignant colonic obstruction has become better defined. However, numerous prospective and retrospective investigations have highlighted serious concerns about a possible worse outcome after endoscopic colorectal stenting as a bridge to surgery, particularly in case of perforation. This review analyzes the most recent evidence in order to highlight pros and cons of SEMS placement in left-sided malignant colonic obstruction.

摘要

左侧恶性结肠梗阻的治疗仍是临床实践中最大的问题之一。在过去几十年里,已有大量关于肿瘤性结肠梗阻结肠支架置入术的研究报道。由此,自膨式金属支架(SEMS)在恶性结肠梗阻治疗中的作用已得到更明确的界定。然而,众多前瞻性和回顾性研究都突出了对内镜下结肠支架置入作为手术桥梁可能导致更差预后的严重担忧,尤其是在发生穿孔的情况下。本综述分析了最新证据,以突出在左侧恶性结肠梗阻中置入SEMS的利弊。

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