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首页> 外文期刊>Surgical Endoscopy >Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease.
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Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease.

机译：经皮内镜下乙状结肠造口术冲洗治疗中枢神经系统疾病成年人的肠功能障碍。

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BACKGROUND: Bowel dysfunction results in a major lifestyle disruption for many patients with severe central neurologic disease. Percutaneous endoscopic sigmoid colostomy for irrigation (PESCI) allows antegrade irrigation of the distal large bowel for the management of both incontinence and constipation. This study prospectively assessed the safety and efficacy of PESCI. METHODS: A PESCI tube was placed endoscopically in the sigmoid colon of 25 patients to allow antegrade irrigation. RESULTS: Control of constipation and fecal incontinence was improved for 21 (84%) of the 25 patients. These patients were followed up for 6-83 months (mean, 43 months), with long-term success for 19 (90%) of the patients. No PESCI had to be removed for technical reasons or for PESCI complications. Late removal of the PESCI was necessary for 2 of the 21 patients. A modified St. Marks Fecal Incontinence Score to assess bowel function before and after PESCI showed a highly significant improvement (P < 0.0001). There were no procedure-related deaths. Complications included minor sepsis at the initial PESCI tube site in four patients and bumper migration in two patients, but there were no complications related to the button device. CONCLUSION: This study showed that PESCI is a simple, safe, and effective technique for distal antegrade irrigation in the management bowel dysfunction for selected patients with central neurologic disease. A successful PESCI is very likely to continue functioning satisfactorily for a long time without technical problems or local complications.
机译：背景：肠功能障碍导致许多患有严重中枢神经系统疾病的患者发生主要的生活方式破坏。经皮内窥镜乙状结肠造瘘术（PESCI）可顺行冲洗远端大肠，以治疗失禁和便秘。这项研究前瞻性评估了PESCI的安全性和有效性。方法：将PESCI管在内窥镜下放置在25例乙状结肠中，以进行顺行冲洗。结果：25例患者中有21例（84％）改善了便秘和大便失禁的控制。对这些患者进行了6-83个月的随访（平均43个月），其中19例（90％）获得了长期成功。无需出于技术原因或PESCI并发症而切除PESCI。 21例患者中有2例需要晚期切除PESCI。修改后的St. Marks粪便失禁评分评估PESCI前后的肠功能显示出非常显着的改善（P <0.0001）。没有与手术相关的死亡。并发症包括四名患者在最初的PESCI管位出现轻微败血症，两名患者发生保险杠移位，但没有与纽扣装置相关的并发症。结论：这项研究表明，对于某些中枢神经系统疾病患者，PESCI是一种简单，安全，有效的远端顺行冲洗技术，可处理肠功能障碍。成功的PESCI很可能会长时间令人满意地继续运行，而不会出现技术问题或局部并发症。

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