在食道胃外科手术后,对肠道泄漏进行支架与内镜真空疗法
Carlo Galdino Riva1, Stefano Siboni1, Matteo Capuzzo1
1Division of General and Emergency Surgery, IRCCS Policlinico San Donato, University of Milan, 20097 Milan, Italy.
Journal of clinical medicine
|October 16, 2025
概括
内镜真空疗法 (EVT) 和自扩展金属支架 (SEMS) 在食道胃外科手术后有效治疗静脉漏 (AL). EVT显示出更少的并发症和更短的治疗时间,使其成为食道-肠道泄漏的首选选择.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 内視鏡外科手術 內視鏡外科手術
背景情况:
- 肠道泄漏 (AL) 是食管胃手术后的一种严重并发症,具有显著的发病率和死亡率.
- 早期内镜干预对于管理AL至关重要,自扩展金属支架 (SEMS) 和内镜真空疗法 (EVT) 是主要的治疗方式.
- 有限的比较数据存在,需要进一步研究SEMS与AL的EVT对AL的安全性和有效性.
研究的目的:
- 为了比较SEMS和EVT在经食道胃外科手术后处理道泄漏 (AL) 的安全性和有效性.
- 评估结果,如愈合率,手术相关并发症和患者康复.
- 为了确定一种内镜处理对另一种特定类型的泄漏的潜在优势.
主要方法:
- 一项使用前性机构数据库 (2012年3月-2025年) 的回顾性病例控制研究.
- 包括AL食管/胃外科手术后接受SEMS或EVT治疗的患者,不包括保守或手术治疗.
- 收集人口统计,并发症,手术和漏洞特定数据;主要结果是完全治愈漏洞,次要结果包括成功的时间,手术数量,住院时间,并发症和死亡率.
主要成果:
- 在45名患者中 (22名SEMS,23名EVT),成功率相似 (86.4%的SEMS与95.6%的EVT).
- EVT显示的并发症率明显较低 (8.3%,相对于SEMS的50%),特别是在迁移和狭窄方面.
- 虽然在EVT中凝肠切除的需要更高,但在SEMS中胸部排水的使用更高;住院时间和整体死亡率在各组之间相似.
结论:
- 无论是SEMS还是EVT,都是一种有效的内镜治疗方法,用于在食道胃外科手术后的解性泄漏 (AL).
- 与SEMS相比,内镜真空疗法 (EVT) 具有有利的安全性,并发症较少.
- 推EVT作为一种首选的治疗方法,特别是对于食道-肠道泄漏,由于其疗效和改善的安全结果.
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