Zhang Anding, Fan Na, Zhang Xinhui, Guo Hongwei, Zhou Ying, Zeng Lingchao, Lin Yan, Jiang Xun
Department of Pediatrics, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China.
Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), No. 1 Xinsi Road, Xi'an, Shaanxi 710038, China.
Therap Adv Gastroenterol. 2024 Sep 24;17:17562848241275314. doi: 10.1177/17562848241275314. eCollection 2024.
Endoscopic retrograde appendicitis therapy (ERAT) is a novel and minimally invasive technological alternative for the management of acute or chronic appendicitis. Through endoscopic appendiceal intubation, obstructions such as appendiceal feces and parasites within the appendiceal lumen can be effectively eliminated, leading to patient recovery. Additionally, in cases where the orifices are swollen or complicated appendicitis is present, a stent may be inserted following appendiceal flushing. Due to the utilization of endoscopy for accessing the orifices of the appendix in order to alleviate appendiceal obstruction, patients were able to avoid undergoing appendectomy and experienced a reduced likelihood of recurrence when compared to antibiotic therapy. Additionally, the ERAT provided alternative options for individuals with appendicitis and comorbidities. Recent advancements in techniques, such as the "mother-baby" endoscopic system and the use of microbubble contrast agents, have expanded the range of indications and the eligible patient populations. The objective of this review is to present a comprehensive overview of the development, procedural aspects, therapeutic principles, treatment efficacy, therapeutic applications, and potential complications associated with ERAT.
内镜逆行性阑尾炎治疗术(ERAT)是一种用于治疗急性或慢性阑尾炎的新型微创技术替代方案。通过内镜下阑尾插管,可有效清除阑尾腔内诸如阑尾粪石和寄生虫等梗阻物,从而使患者康复。此外,在阑尾开口肿胀或存在复杂性阑尾炎的情况下,可在阑尾冲洗后插入支架。由于利用内镜进入阑尾开口以缓解阑尾梗阻,与抗生素治疗相比,患者能够避免接受阑尾切除术,且复发可能性降低。此外,ERAT为患有阑尾炎及合并症的个体提供了替代选择。诸如“母子”内镜系统和微泡造影剂使用等技术的最新进展,扩大了ERAT的适应证范围和符合条件的患者群体。本综述的目的是全面概述与ERAT相关的发展、操作方面、治疗原则、治疗效果、治疗应用及潜在并发症。