中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2012年
2期
85-87
,共3页
张杰%陈婧%张谨芬%武沪平%郝建宇
張傑%陳婧%張謹芬%武滬平%郝建宇
장걸%진청%장근분%무호평%학건우
金属支架%恶性结肠病变%肠梗阻
金屬支架%噁性結腸病變%腸梗阻
금속지가%악성결장병변%장경조
Metal stent%Malignant colonic disease%Bowel obstruction
目的 探讨结直肠金属支架置入术对左半结肠癌所致肠梗阻的治疗价值.方法 对2007年5月至2011年5月因左半结肠癌肠梗阻接受结直肠金属支架置入术的29例患者的病例资料进行回顾性分析.结果 27例成功进行支架置入术,腹胀、呕吐症状缓解,2例由于病变肠段较长,高度水肿,完全阻塞肠腔,导丝无法通过而未成功,支架置入成功率92.6％ (27/29).置入支架的27例中24例成功进行了Ⅰ期左半结肠切除无张力吻合术,术中发现支架穿透肠壁1例(1/27,3.7％),手术后好转,围手术期无死亡病例发生,平均住院天数11.7 d；3例未接受手术治疗者支架通畅时间平均为5个月.结论 对于左半结肠癌所致肠梗阻,金属支架置入术可有效解除梗阻,并作为过渡治疗,利于手术前进行充分的肠道准备,为择期行外科肿瘤根治术创造条件.
目的 探討結直腸金屬支架置入術對左半結腸癌所緻腸梗阻的治療價值.方法 對2007年5月至2011年5月因左半結腸癌腸梗阻接受結直腸金屬支架置入術的29例患者的病例資料進行迴顧性分析.結果 27例成功進行支架置入術,腹脹、嘔吐癥狀緩解,2例由于病變腸段較長,高度水腫,完全阻塞腸腔,導絲無法通過而未成功,支架置入成功率92.6％ (27/29).置入支架的27例中24例成功進行瞭Ⅰ期左半結腸切除無張力吻閤術,術中髮現支架穿透腸壁1例(1/27,3.7％),手術後好轉,圍手術期無死亡病例髮生,平均住院天數11.7 d；3例未接受手術治療者支架通暢時間平均為5箇月.結論 對于左半結腸癌所緻腸梗阻,金屬支架置入術可有效解除梗阻,併作為過渡治療,利于手術前進行充分的腸道準備,為擇期行外科腫瘤根治術創造條件.
목적 탐토결직장금속지가치입술대좌반결장암소치장경조적치료개치.방법 대2007년5월지2011년5월인좌반결장암장경조접수결직장금속지가치입술적29례환자적병례자료진행회고성분석.결과 27례성공진행지가치입술,복창、구토증상완해,2례유우병변장단교장,고도수종,완전조새장강,도사무법통과이미성공,지가치입성공솔92.6％ (27/29).치입지가적27례중24례성공진행료Ⅰ기좌반결장절제무장력문합술,술중발현지가천투장벽1례(1/27,3.7％),수술후호전,위수술기무사망병례발생,평균주원천수11.7 d；3례미접수수술치료자지가통창시간평균위5개월.결론 대우좌반결장암소치장경조,금속지가치입술가유효해제경조,병작위과도치료,리우수술전진행충분적장도준비,위택기행외과종류근치술창조조건.
Objective To investigate the therapeutic value of endoscopic implantation of metal stents for obstruction caused by left-sided malignant colorectal tumor.Methods Data of 29 patients with left-sided malignant colonic obstruction who underwent stenting from May 2007 to May 2011 were retrospectively analyzed.Results Self-expanding metal stents were successfully implanted in 27 patients.Symptoms of abdominal distention and vomiting subsided in these patients.The procedure failed in 2 patients (2/29,6.9％ ),because the guidewire failed to pass the colonic stricture due to edema and the length of the diseased colon.Technical success was achieved in 27 of total 29 patients (27/29,92.6％ ).Out of the 27 patients,stage Ⅰ primary left-sided colonic resection and anastomosis were successfully performed in 24 patients.Colonic perforation was found intraoperatively in 1 patient ( 1/27,3.7％ ) who subsequently recovered after operation.There was no death during the perioperative period with the average hospital stay of 11.7 days.A mean colonic stent patency for 5 months was observed in 3 patients who underwent palliative stenting only.Conclusion Endoscopic implantation of metal stents is effective for left-sided malignant colorectal obstruction.As a bridge to surgery,it facilitates sufficient bowel preparation for elective radical operation.
