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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.

DOI:10.1590/0102-6720202400053e1847
PMID:39699383
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11655071/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/d9ca5816cb37/0102-6720-abcd-37-e1847-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/dae0382e4c32/0102-6720-abcd-37-e1847-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/4ce951e6bd07/0102-6720-abcd-37-e1847-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/d9ca5816cb37/0102-6720-abcd-37-e1847-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/dae0382e4c32/0102-6720-abcd-37-e1847-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/4ce951e6bd07/0102-6720-abcd-37-e1847-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca1/11655071/d9ca5816cb37/0102-6720-abcd-37-e1847-gf03.jpg

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本文引用的文献

1
BRAZILIAN HERNIA AND ABDOMINAL WALL SOCIETY STATEMENT ON LARGE HIATAL HERNIAS MANAGEMENT.巴西疝与腹壁外科学会关于大型食管裂孔疝管理的声明。
Arq Bras Cir Dig. 2024 Feb 5;36:e1787. doi: 10.1590/0102-672020230069e1787. eCollection 2024.
2
LAPAROSCOPIC ANTIREFLUX SURGERY: ARE OLD QUESTIONS ANSWERED? MESH HERNIOPLASTY.腹腔镜抗反流手术:旧问题有答案了吗?网片修补术。
Arq Bras Cir Dig. 2023 Jan 9;35:e1710. doi: 10.1590/0102-672020220002e1710. eCollection 2023.
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Laparoscopic Paraesophageal Hernia Repair: To Mesh or not to Mesh. Systematic Review and Meta-analysis.
腹腔镜食管裂孔疝修补术:是否使用补片?系统评价和荟萃分析。
Ann Surg. 2022 Jan 1;275(1):67-72. doi: 10.1097/SLA.0000000000004913.
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Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA).食管裂孔疝在非对比 CT 中的患病率和自然史:多民族动脉粥样硬化研究(MESA)。
BMJ Open Gastroenterol. 2021 Mar;8(1). doi: 10.1136/bmjgast-2020-000565.
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Mesh-related complications in paraoesophageal repair: a systematic review.食管旁疝修补术中的网片相关并发症:系统评价。
Surg Endosc. 2020 Oct;34(10):4257-4280. doi: 10.1007/s00464-020-07723-0. Epub 2020 Jun 18.
6
Mesh erosion after hiatal hernia repair: the tip of the iceberg?食管裂孔疝修补术后网片侵蚀:冰山一角?
Hernia. 2019 Dec;23(6):1243-1252. doi: 10.1007/s10029-019-02011-w. Epub 2019 Jul 23.
7
GERD: Presence and Size of Hiatal Hernia Influence Clinical Presentation, Esophageal Function, Reflux Profile, and Degree of Mucosal Injury.胃食管反流病:食管裂孔疝的存在及大小影响临床表现、食管功能、反流情况及黏膜损伤程度。
Am Surg. 2018 Jun 1;84(6):978-982.
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'Mesh hiatal hernioplasty' versus 'suture cruroplasty' in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis.腹腔镜食管裂孔疝修补术中“网片膈肌裂孔成形术”与“缝线折叠术”的比较:系统评价和荟萃分析。
Asian J Surg. 2019 Jan;42(1):53-60. doi: 10.1016/j.asjsur.2018.05.001. Epub 2018 Jun 7.
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10
Late esophageal wall injury after mesh repair for large esophageal hiatal hernia: a case report.大型食管裂孔疝补片修补术后迟发性食管壁损伤:一例报告
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