...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Use of a specially designed partially covered self-expandable metal stent (PSEMS) with a 40-mm diameter for the treatment of upper gastrointestinal suture or staple line leaks in 11 cases
【24h】

Use of a specially designed partially covered self-expandable metal stent (PSEMS) with a 40-mm diameter for the treatment of upper gastrointestinal suture or staple line leaks in 11 cases

机译：使用特别设计的直径40毫米的部分覆盖的自膨胀金属支架（PSEMS）来治疗11例上消化道缝合线或吻合钉缝合线渗漏

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Introduction: The use of self-expandable stents to treat postoperative leaks and fistula in the upper gastrointestinal (GI) tract is an established treatment for leaks of the upper GI tract. However, lumen-to-stent size discrepancies (i.e., after sleeve gastrectomy or esophageal resection) may lead to insufficient sealing of the leaks requiring further surgical intervention. This is mainly due to the relatively small diameter (≤30 mm) of commonly used commercial stents. To overcome this problem, we developed a novel partially covered stent with a shaft diameter of 36 mm and a flare diameter of 40 mm. Methods: From September 2008 to September 2010, 11 consecutive patients with postoperative leaks were treated with the novel large diameter stent (gastrectomy, n = 5; sleeve gastrectomy, n = 2; fundoplication after esophageal perforation, n = 2; Roux-en-Y gastric bypass, n = 1; esophageal resection, n = 1). Treatment with commercially available stents (shaft/flare: 23/28 mm and 24/30 mm) had been unsuccessful in three patients before treatment with the large diameter stent. Due to dislocation, the large diameter stent was anchored in four patients (2× intraoperatively with transmural sutures, 2× endoscopically with transnasally externalized threads). Results: Treatment was successful in 11 of 11 patients. Stent placement and removal was easy and safe. The median residence time of the stent was 24 (range, 18-41) days. Stent dislocation occurred in four cases (36 %). It was treated by anchoring the stent. Mean follow-up was 25 (range, 14-40) months. No severe complication occurred during or after intervention and no patient was dysphagic. Conclusions: Using the novel large diameter, partially covered stent to seal leaks in the upper GI tract is safe and effective. The large diameter of the stent does not seem to injure the wall of the upper GI tract. However, stent dislocation sometimes requires anchoring of the stent with sutures or transnasally externalized threads.
机译：简介：使用自扩张式支架治疗上消化道（GI）的术后渗漏和瘘管是上消化道渗漏的公认治疗方法。但是，管腔至支架大小的差异（即在进行袖状胃切除术或食管切除术后）可能会导致密封不充分，需要进一步的手术干预。这主要是由于常用的商用支架的直径相对较小（≤30 mm）。为了克服这个问题，我们开发了一种新型的部分覆盖支架，其轴直径为36 mm，喇叭口直径为40 mm。方法：自2008年9月至2010年9月，连续11例术后渗漏患者接受了新型大直径支架置入术（胃切除术，n = 5;袖胃切除术，n = 2;食管穿孔后胃底折叠术，n = 2; Roux-en- Y胃旁路手术，n = 1;食道切除，n = 1）。在使用大直径支架治疗之前，三名患者使用市售支架（轴/扩口：23/28 mm和24/30 mm）治疗均未成功。由于脱位，大直径支架被锚固在四名患者中（术中用透壁缝线缝合2次，内窥镜用经鼻外螺纹缝合2次）。结果：11例患者中有11例治疗成功。支架的放置和移除既简单又安全。支架的中位停留时间为24天（范围18-41）。支架脱位4例（36％）。通过固定支架进行治疗。平均随访时间为25（14-40）个月。干预期间或之后均未发生严重并发症，也没有吞咽困难的患者。结论：使用新颖的大直径，部分覆盖的支架密封上消化道的渗漏是安全有效的。支架的大直径似乎不会损伤上消化道的壁。但是，支架脱位有时需要用缝合线或经鼻外螺纹固定支架。

著录项

相似文献

  • 外文文献
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号