• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent.
【24h】

Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent.

机译：内窥镜治疗可食管穿孔或吻合口漏孔的自扩张金属支架。

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

BACKGROUND: Leaks of the esophagus are associated with a high mortality rate and need to be treated as soon as possible. Therapeutic options are surgical repair or resection or conservative management with cessation of oral intake and antibiotic therapy. We evaluated an alternative approach that uses self-expandable metallic stents (SEMS). METHODS: Between 2002 and 2007, 31 consecutive patients with iatrogenic esophageal perforation (n = 9), intrathoracic anastomotic leak after esophagectomy (n = 16), spontaneous tumor perforation (n = 5), and esophageal ischemia (n = 1) were treated at our institution. All were treated with endoscopic placement of a covered SEMS. Stent removal was performed 4 to 6 weeks after implantation. To exclude continuous esophageal leak after SEMS placement, radiologic examination was performed after stent implantation and removal. RESULTS: SEMS placement was successful in all patients and a postinterventional esophagogram demonstrated full coverage of the leak in 29 patients (92%). In two patients, complete sealing could not be achieved and they were referred to surgical repair. Stent migration was seen in only one patient (3%). After removal, a second stent with larger diameter was placed and no further complication occurred. Two patients died: one due to myocardial infarction and one due to progressive ischemia of the esophagus and small bowl as a consequence of vascular occlusion. Stent removal was performed within 6 weeks, and all patients had radiologic and endoscopic evidence of esophageal healing. CONCLUSIONS: Implantation of covered SEMS in patients with esophageal leak or perforation is a safe and feasible alternative to operative treatment and can lower the interventional morbidity rate.
机译：背景：食道渗漏与高死亡率有关，需要尽快进行治疗。治疗选择是手术修复或切除或保守治疗，以及停止口服和抗生素治疗。我们评估了使用自膨胀金属支架（SEMS）的替代方法。方法：在2002年至2007年之间，连续治疗了31例医源性食管穿孔（n = 9），食管切除术后胸腔内吻合口漏（n = 16），自发性肿瘤穿孔（n = 5）和食管缺血（n = 1）。在我们的机构。所有患者均接受内镜覆盖的SEMS治疗。植入后4至6周进行支架清除。为了排除SEMS放置后食管的持续渗漏，在支架植入和取出后进行了放射学检查。结果：所有患者均成功完成了SEMS植入，介入后的食管造影表明29例患者的渗漏被完全覆盖（92％）。在两名患者中，无法实现完全密封，因此将他们转介至手术修复。仅一名患者（3％）可见支架移位。取出后，放置直径更大的第二个支架，没有发生进一步的并发症。 2例患者死亡：1例由于心肌梗死，1例由于食管和小碗由于血管闭塞而进行性局部缺血。在6周内进行了支架切除术，所有患者均具有放射学和内镜检查证明食管愈合。结论：食管渗漏或穿孔患者植入有盖SEMS是手术治疗的一种安全可行的替代方法，并且可以降低介入发病率。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
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