逆行器具支援の金属ステント挿入 キャンディ・キャンの症候群
Anne Kimberly Lim-Fernandez1,2, Samuel Jun Ming Lim1, Chin Hong Lim3
1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
まとめ
胃外科手術の稀な合併症である キャンディ・キャンの症候群は 内視鏡で効果的に治療できます 膜を挿入する金属ステント (LAMS) は,閉塞症状を緩和するために,手術よりも侵襲性の少ない代替手段を提供します.
科学分野:
- 胃腸内科
- 手術 の 合併 症
- エンドスコピーの手順
背景:
- キャンディ・キャンの症候群は 胃バイパスや胃切除手術後の 珍しい合併症です
- 食物で満たされ 嘔吐のような 閉塞症状を引き起こします
- 手術による切除は治癒的ですが,挑戦的です. ルーメン付属の金属ステント (LAMS) を用いた内視鏡治療も検討されています.
研究 の 目的:
- キャンディーキャンの症候群の管理のための新しい内視鏡アプローチを記述します.
- 複合的なケースにおいて,逆行的な光付金属ステント (LAMS) の挿入の有効性を評価する.
主な方法:
- トランデム内視鏡アプローチを用いてリトログラード・ルメン・アポッシング・メタル・ステント (LAMS) を挿入した.
- 精密なステントの配置のために,超薄ガストロスコプとエコーエンドスコプが使用されました.
- 塩溶液の挿入と内視鏡の可視化により,LAMSがエフェレントの肢から盲目の頭皮袋に安全に展開することが確認された.
主要な成果:
- 患者の体重は4ヶ月で9kg増えました.
- 処置後には正常な食事耐性が認められた.
- LAMSは10~12ヶ月後に除去され,長期にわたる透かし性を確保することを目的とした.
結論:
- EUS誘導のLAMS挿入による内視鏡治療は,キャンディ・キャネ症候群の手術の実行可能で有望な代替手段である.
- この逆行的なアプローチは 食品の効率的な転換と 状態の管理を容易にする.
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