食管裂孔疝修补术后补片移位的内镜治疗
ENDOSCOPIC MANAGEMENT OF MESH MIGRATION FOLLOWING HIATAL HERNIA REPAIR.
作者信息
Martins Bruno Costa, Martins E Silva Adrielma Athena Rodrigues Serrão, Soares Ada Alexandrina Brom Dos Santos, Ribeiro Junior Ulysses
机构信息
Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology - São Paulo (SP), Brazil.
Hospital Alemão Oswaldo Cruz, Endoscopy Unit - São Paulo (SP), Brazil.
出版信息
Arq Bras Cir Dig. 2024 Dec 16;37:e1847. doi: 10.1590/0102-6720202400053e1847. eCollection 2024.
BACKGROUND
The use of mesh in the repair of large hiatal hernias is still controversial. One of the most feared adverse events related to the use of mesh is erosion into the esophageal and gastric walls.
AIMS
To record the endoscopic treatment of mesh that has migrated into the gastric lumen after surgical treatment of hiatal hernia.
METHODS
The technical option was to wait for the progressive migration of the mesh into the gastric lumen, monitoring with upper digestive endoscopy, with removal by traction at the best time, with the aid of foreign body forceps.
RESULTS
The mesh was completely removed, and the evolution was satisfactory, without complications.
CONCLUSIONS
In patients with mesh migration into the stomach who are oligosymptomatic and do not show signs of complications, endoscopic surveillance and subsequent removal of the foreign body can be successfully performed when the mesh is not adhered to the gastric wall, avoiding surgical procedures with high morbidity and mortality.
背景
在大型食管裂孔疝修补术中使用补片仍存在争议。与使用补片相关的最令人担忧的不良事件之一是补片侵蚀食管和胃壁。
目的
记录食管裂孔疝手术治疗后补片移入胃腔的内镜治疗情况。
方法
技术选择是等待补片逐渐移入胃腔，通过上消化道内镜监测，在最佳时机借助异物钳通过牵引将其取出。
结果
补片被完全取出，病情进展令人满意，无并发症。
结论
对于补片移入胃内且症状轻微、无并发症迹象的患者，当补片未粘连于胃壁时，可成功进行内镜监测并随后取出异物，避免具有高发病率和死亡率的外科手术。
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