双球囊导管成形术治疗结直肠吻合口良性狭窄

目的评价透视下双球囊导管成形术治疗结直肠吻合口良性狭窄的疗效。方法17例结直肠吻合口良性狭窄的患者,在透视下行经肛门双球囊导管成形术。13例因恶性、4例因良性病变而接受结、直肠外科手术。16例因部分性梗阻表现为排便困难或排便次数增多,1例患者因溃疡性结肠炎,作全结肠切除术 临时性肠造瘘术后,其吻合口狭窄由内镜和钡灌肠检查发现并确定为良性。随访期观察疗效和并发症。结果17例患者在透视下进行了双球囊导管成形术1次。双球囊扩张成形术中,先用单球囊(直径为20mm)作为初步扩张,再附加第2枚球囊(直径为10、15或20mm)进行双球囊导管成形术。技术成功率为100%。球囊导管成形术后,症状完全改善12例(71%)、部分改善5例(29%)。未发生如肠破裂或严重出血等并发症。平均随访23个月(1～62个月),1例6个月后狭窄复发,给予再次双球囊导管成形术后,狭窄症状消失。结论透视下双球囊导管成形治疗良性结直肠吻合口狭窄安全可行。     

针织状聚二氧六环酮生物可降解支架:一种对于良恶性食管狭窄的新型治疗选择

<正>背景介绍一种采用新型生物可降解的食管支架置于2例病人体内的最初经验,1例是针对治疗阻力性良性食管狭窄病人,另1例是作为食管癌病人的治愈性放射治疗中的暂行措施。方法生物     

采用携带可生物降解的聚对二氧环己酮(polydoxanone)的胆道支架对难以采用标准胆道成形术的良性胆管狭窄进行治疗:107例病人的回顾性多中心数据分析

<正>摘要目的评估可生物降解的胆道支架对于难以进行标准胆道成形术的良性胆道狭窄治疗的中期预后。方法机构伦理委员会通过此项研究,本研究无需病人的知情同意     

Biodegradable polydioxanone stents: a new option for therapy-resistant anastomotic strictures of the colon

Objectives  

To assess the outcome of self-expandable, biodegradable stent insertion for anastomotic strictures following treatment for rectosigmoid carcinoma.     

Woven polydioxanone biodegradable stents: a new treatment option for benign and malignant oesophageal strictures

Background  

We present our initial experience with a new biodegradable (BD) esophageal stent in two patients, one for a therapy-resistant benign esophageal stricture, and the other as a temporary measure during curative radiotherapy for oesophageal carcinoma.     

Palliation of postoperative gastrointestinal anastomotic malignant strictures with flexible covered metallic stents: Preliminary results

Purpose: To evaluate the efficacy of the placement of covered metallic stents for palliation of gastrointestinal anastomotic strictures secondary to recurrent gastric cancer. Methods: Under fluoroscopic guidance, placement of one or two self-expandable covered metallic stents was attempted perorally in 11 patents (aged 48–76 years) with anastomotic stenoses due to recurrent gastric malignancies. The strictures involved both the afferent and efferent loops in three patients. All patients had poor peroral food intake with severe nausea and vomiting after ingestion. The technical and clinical success was evaluated. Results: Placement of the covered stent was technically successful in 13 of 15 (87%) attempts in ten patients. After the procedure, 9 of 11 (82%) patients overall were able to ingest at least a liquid diet and had markedly decreased incidence of vomiting. During the follow-up of 2–31 weeks (mean 8.5 weeks) there were no major complications. Conclusion: These preliminary results suggest that flexible, covered stents may provide effective palliation of malignant anastomotic stricture secondary to recurrent gastric cancer.     

Ureteroplasty with a cutting balloon: a novel approach to ureteric anastomotic strictures

The Peripheral Cutting Balloon device was originally described to treat in-stent coronary artery stenosis. We aim to evaluate the use of this device in the management of ureteric anastomotic strictures. Four patients with radiologically proven ureteric anastomotic strictures were treated with the Peripheral Cutting Balloon Device using an antegrade approach. Follow up ranged between 2 and 12 months. All patients' initial procedure was successful, and all patients had improvement of symptoms. No patient showed evidence of biochemical deterioration of renal function, and no periprocedural complications occurred. One patient had restenosis as a result of invasive bladder cancer and required subsequent cystectomy. The Peripheral Cutting Balloon device is a novel instrument for the treatment of ureteric anastomotic strictures. Our experience shows promising short-term results but more follow up is required.     

Antegrade double J ureteral stenting for ureteric strictures: use of silicone stents

In 16 patients with ureteric strictures, silicone double J ureteral stents were inserted antegradely following percutaneous nephrostomy. In 9 patients prior attempt at retrograde placement of a stent had failed. Balloon dilatation of the stricture using angiographic catheters was also performed in 5 patients. The ureteric strictures were most commonly caused by malignant infiltration, post operative fibrosis, infection and ureteric calculi. Most previous reports have described the use of polyethylene and polyurethrane stents. Technical problems with the use of silicone stents are discussed. Although silicone stents are better tolerated by patients and associated with low complication rates, in 5 of 18 stents inserted (28%) the procedure failed. Suboptimal positioning of the stent due to poor radio-opacity and premature occlusion were the causes. With the availability of co-polymer stents, it is likely that these will replace silicone stents as the stent material of choice for antegrade insertion.