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经前列腺切除内镜器械引导下结肠留置引流支架治疗复杂性肠瘘:一例报告

Complex intestinal fistula treated with colon‑indwelling drainage stent under prostate resection endoscopy instrumentation guidance: A case report.

作者信息

Wang Caihong, Tu Song, Yang Faying, Qin Yujie, Qian Jun, Yao Jiaxi

机构信息

Department of Nursing, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China.

Department of General Surgery II, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China.

出版信息

Exp Ther Med. 2024 Aug 1;28(4):384. doi: 10.3892/etm.2024.12673. eCollection 2024 Oct.

Abstract

The treatment of complex intestinal fistulas has been a challenge in general surgery. A complex fistula is defined as a fistula with more than one abnormal connection between the gastrointestinal tract and skin, or a fistula with multiple bowel loops. The present case report describes the minimally invasive treatment of a complex intestinal fistula. Briefly, a 51-year-old man presented with an intestinal fistula. Following adequate anti-infective drainage of the abdominal abscess, transurethral prostate resection instrumentation was used to flush and drain the intestinal drainage tubes. On reduction of leakage, a drainage tube was inserted into the intestinal tract to serve as an internal stent. Imaging confirmed the successful cessation of intestinal leakage and a satisfactory recovery. The drainage tube was removed under colonoscopy, restoring normal small intestine function. To summarize, after sufficient drainage, the leakage gradually decreased, promoting healing; the patient achieved full recovery upon removal of the internal stent via colonoscopy and the establishment of a small intestinal stoma. In conclusion, transurethral prostate resection instrumentation enables safe and minimally invasive placement of intestinal stents, ensuring effective drainage for managing intestinal fistulas.

摘要

复杂肠瘘的治疗一直是普通外科的一项挑战。复杂瘘被定义为胃肠道与皮肤之间存在不止一个异常连接的瘘,或涉及多个肠袢的瘘。本病例报告描述了复杂肠瘘的微创治疗。简要情况如下,一名51岁男性患有肠瘘。在对腹部脓肿进行充分的抗感染引流后,使用经尿道前列腺切除器械冲洗并引流肠引流管。在漏液减少后,将一根引流管插入肠道作为内部支架。影像学检查证实肠漏成功停止且恢复情况良好。在结肠镜检查下取出引流管,小肠功能恢复正常。总之,在充分引流后,漏液逐渐减少,促进了愈合;通过结肠镜检查取出内部支架并建立小肠造口后,患者完全康复。综上所述,经尿道前列腺切除器械能够安全、微创地放置肠道支架,确保对肠瘘进行有效引流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7dc/11332139/3f8ffb23820b/etm-28-04-12673-g00.jpg

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