Holzwanger Daniel J, Trikantzopolous Elefterios, Nauheim David, Chauhan Anupam S, Milsom Jeffrey W, Pua Bradley B
Division of Vascular and Interventional Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York.
Center for Intelligent Image Guided Interventions (CI3), New York, New York.
Semin Intervent Radiol. 2025 Jan 29;42(1):75-81. doi: 10.1055/s-0044-1801335. eCollection 2025 Feb.
Interventional radiology techniques using image guidance have revolutionized healthcare by enabling less invasive approaches for "difficult-to-treat" conditions. Complex gastrointestinal (GI) conditions such as bowel obstructions, enterocutaneous fistulas, and other enteric maladies are major causes of morbidity and mortality; are rising in incidence worldwide; and may benefit from the integration of interventional radiology techniques into current surgical/endoscopic management strategies, analogous to cardiovascular interventions of the past few decades. Conservative medical management of these intestinal conditions can fail or result in extended hospital admissions and poor quality of life, while current operative management can be fraught with complications and death, especially in high-risk patients with prior abdominal surgeries. The prevalence of GI conditions requiring intervention and the potential for complications and morbidity with current methods, including laparoscopy, suggests that this is a field ripe for innovation. This article outlines an innovative approach to managing complex GI problems that we are developing at our institution, combining interventional radiological techniques with advanced surgical/endoscopic methods. Specifically, we attempt to highlight the benefits of a multidisciplinary team using advanced imaging guidance to perform novel percutaneous, endoscopic, and surgical procedures for high-surgical risk patients with intestinal problems requiring intervention.
使用影像引导的介入放射学技术通过为“难以治疗”的病症提供侵入性较小的治疗方法，彻底改变了医疗保健。复杂的胃肠道（GI）病症，如肠梗阻、肠皮肤瘘和其他肠道疾病，是发病和死亡的主要原因；在全球范围内发病率不断上升；并且可能受益于将介入放射学技术整合到当前的外科/内镜治疗策略中，这类似于过去几十年的心血管介入治疗。对这些肠道疾病进行保守的药物治疗可能会失败，或者导致住院时间延长和生活质量下降，而目前的手术治疗可能充满并发症和死亡风险，尤其是在有腹部手术史的高危患者中。需要干预的胃肠道疾病的患病率以及包括腹腔镜检查在内的当前治疗方法出现并发症和发病的可能性，表明这是一个亟待创新的领域。本文概述了我们机构正在开发的一种管理复杂胃肠道问题的创新方法，该方法将介入放射学技术与先进的外科/内镜方法相结合。具体而言，我们试图强调多学科团队利用先进的影像引导为有肠道问题且需要干预的高手术风险患者实施新型经皮、内镜和外科手术的益处。
