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首页> 外文期刊>Surgical Endoscopy >Clinical outcomes of endoscopic and surgical management for postoperative upper gastrointestinal leakage.
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Clinical outcomes of endoscopic and surgical management for postoperative upper gastrointestinal leakage.

机译：内镜和手术治疗术后上消化道渗漏的临床结果。

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The purpose of this study was to evaluate the safety and efficacy of endoscopic therapy, an alternative and less invasive modality for the management of leakage after gastrectomy.An electronic database of 35 patients with anastomotic leaks after surgery for stomach cancer that were treated with either an endoscopic procedure or surgery between January 2004 and March 2012 was reviewed. The success rates and safety of both modalities were evaluated.Endoscopic treatment was performed in 20 patients and surgical treatment in 15 patients. The median time interval between the primary surgery and diagnosis of leakage was 8.0 days (interquartile range, 5.0-14.0 days). Of the 20 patients with endoscopic treatment, technical success was achieved in 19 patients (95 %) with resulting clinical success achieved in all of these 19 patients (100 %). One patient with failed endoscopic management went on to receive surgery. There were no cases of leakage-related deaths after endoscopic treatment. Of the 15 patients with surgical treatment, 5 died due to sepsis, bleeding, or hospital-acquired pneumonia. For diagnosis of leakage, 17 patients from the endoscopy group underwent computed tomography (CT) scanning, which revealed leakages in 3 patients (17.6 %) and occult leakages were subsequently defined at fluoroscopy in all 20 patients. Seven of twelve patients (58.3 %) from the surgical group had leakages diagnosed by CT scan.Endoscopic treatment can be considered a valuable option for the management of postoperative anastomotic leakage with a high degree of technical feasibility and safety, particularly for leakages that are not excessively large.
机译：这项研究的目的是评估内镜治疗的安全性和有效性，这是治疗胃切除术后渗漏的另一种微创方法。电子数据库包含35例胃癌术后吻合口漏的患者，这些患者均接受了内镜治疗回顾了2004年1月至2012年3月之间的内镜手术或手术。评价两种方式的成功率和安全性。内镜治疗20例，外科手术治疗15例。初次手术与漏诊之间的中位时间间隔为8.0天（四分位间距为5.0-14.0天）。在20例接受内镜治疗的患者中，有19例（95％）取得了技术成功，所有19例（100％）均取得了临床成功。一名内镜治疗失败的患者继续接受手术。在内窥镜治疗后，没有因泄漏引起的死亡。在15例接受手术治疗的患者中，有5例因败血症，出血或医院获得性肺炎而死亡。为了诊断渗漏，对内窥镜检查组的17例患者进行了计算机断层扫描（CT）扫描，结果发现3例渗漏（17.6％），随后在所有20例患者的透视下均发现了隐性渗漏。手术组的十二名患者中有七名（58.3％）经CT扫描诊断为渗漏。内镜治疗被认为是术后吻合口渗漏管理的有价值的选择，具有高度的技术可行性和安全性，特别是对于那些没有手术的渗漏太大。

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