在患有耐火性胃关节静脉狭窄症患者的EUS辅助胃出口重塑中
Kambiz Kadkhodayan1, Saurabh Chandan1, Sagar Pathak1
1Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.
概括
耐火性胃关狭窄的内镜管理可以通过EUS引导的胃出口改造 (EUS-GOR) 来实现. 这种新的方法为患有Roux-en-Y胃绕道并发症的患者提供了最少的侵入性选择.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 内镜治疗药物 内镜治疗药物
背景情况:
- 胃外关节 (GJ) 静脉狭窄影响高达30%的Roux-en-Y胃绕道术患者.
- 许多患者在耐火性狭窄症的内镜治疗失败后需要修复性手术.
研究的目的:
- 提出一种新的逐步方法,用于对耐火性GJ狭窄的最终内镜治疗.
- 评估EUS导向胃出口改造 (EUS-GOR) 对这些狭窄的可行性和有效性.
主要方法:
- 一名56岁的女性患有耐火性关节收缩,接受了EUS-GOR.
- 两种对照光体的金属支架 (LAMS) 被平行放置在横跨解剖体并进入 afferent 肢体.
- 在组织通道成熟和预防性 suturing 后进行了分管切除.
主要成果:
- EUS-GOR程序被很好地容忍,没有任何不良事件.
- 在3个月的随访中,GJ解剖直径增加到20毫米.
- 患者的体重指数在12个月内从16.5升至22.4公斤/平方米.
结论:
- 以EUS为指导的胃出口改造 (EUS-GOR) 是一种可行的内镜选择,用于耐火性GJ解剖狭窄.
- 这种微创手术为选定的患者提供了最终的管理策略.
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