自扩张的金属支架在由分泌管疾病引起的结直肠阻塞中 - 一个系统性审查
Sebastian Radic Eskemose1,2, Ola Selnes3, Camilla Thorndal4,3
1Research Unit of Surgery, Odense University Hospital, Svendborg, Denmark. sebastian.radic.eskemose@rsyd.dk.
Surgical endoscopy
|August 26, 2025
概括
自扩张的金属支架 (SEMS) 显示出对转节障碍的希望,并取得了很高的成功率. 然而,与恶性病例相比,它们具有较高的穿孔风险,因此需要进一步研究.
科学领域:
- 胃肠病学
- 大肠直肠手术
- 干预性内镜
背景情况:
- 管疾病引起的结肠直肠阻塞存在独特的管理挑战.
- 在这种情况下,自扩张金属支架 (SEMS) 的有效性和安全性尚未得到充分证实.
- 目前文献缺乏关于非恶性结直肠阻塞的全面数据.
研究的目的:
- 评估使用SEMS治疗因分泌器疾病引起的结直肠阻塞的技术和临床结果.
- 评估与SEMS安置相关的并发症率,包括死亡率.
- 将SEMS结果与恶性阻塞的结果进行比较.
主要方法:
- 在主要数据库 (Embase,MEDLINE,Scopus,Web of Science,Cochrane) 和临床试验网站上进行了系统的文献搜索.
- 包括的研究使用非随机研究方法指数 (MINORS) 进行了质量评估.
- 由于异质性和有限的数据,研究结果进行了定性综合.
主要成果:
- 分析了涉及110名患者的27项研究,20项是观察性研究,7项是病例研究.
- 在观察性研究中,技术和临床成功率高 (分别为92. 7%和83. 5%).
- 最常见的并发症是穿孔 (13. 2%),与手术相关的死亡率为 2.7%. 此外还发现了迁移 (8.5%) 和再阻塞 (5.9%). 在大多数病例中,SEMS作为通往手术的桥梁,其中56.8%避免了口腔.
结论:
- 自扩张的金属支架 (SEMS) 对于转节阻塞的技术和临床成功程度与恶性阻塞相美,但穿孔风险更高.
- SEMS可以作为一个有效的短期桥梁到手术,可能减少对口腔的需求.
- 鉴于现有文献的局限性和偏差风险,进一步进行高质量的研究对于明确SEMS在管结直肠阻塞的作用和优化使用至关重要.
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