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内镜下尼龙绳套扎治疗大肠息肉 总被引:13,自引:0,他引:13
目的 探讨内镜下尼龙绳套扎法治疗宽基底或粗蒂的大肠息肉的价值。方法 将尼龙绳圈通过肠镜操纵把手套扎于息肉根部。结果 本组32例共40枚大肠宽基底或粗蒂息肉均一次性套扎成功,11枚同时加高频电切除。术后2周复查示30枚息肉完全脱落消失(含已用切除者),6枚部分脱落,治愈率、有效率、无效率分别为78.9%、15.8%、5.3%。所有病例未见出血、穿孔等并发症。结论 尼龙绳套扎法对宽基底或粗蒂的大肠息肉治疗效果满意,并发症少。 相似文献
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Background Inadequate closure of the appendix stump can lead to abscess formation or peritonitis. This prospective randomized clinical trial was performed to evaluate the number of endoloops needed in laparoscopic appendectomy.Methods A total of 208 patients were randomized in two groups: 109 in group 1 using one and 99 in group 2 using two proximal endoloops. The groups were compared in terms of intra- and postoperative complications.Results Postoperative complications were found in five patients (4.6%) in group 1, consisting of intraabdominal abscesses (three patients), pulmonary embolism (one patient), and persisting port-site pain (one patient). In group 2, postoperative complications were found in five patients (5.1%), consisting of intraabdominal abscesses (four patients) and prolonged percutaneous drainage (one patient). There was no significant difference between the two groups.Discussion In acute appendicitis, a minimal inflamed appendix base can be safely divided using one endoloop.Presented at the 9th EAES annual congress in Maastricht, 13–16 June 2001 相似文献
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内镜下尼龙绳套扎治疗消化道隆起性病变--附49例报告 总被引:2,自引:0,他引:2
目的:探讨内镜下尼龙绳套扎治疗宽基底或粗蒂消化道隆起性病变的临床疗效.方法:采用内镜下尼龙绳套扎法对49例宽基底或粗蒂消化道隆起性病变进行套扎,观察其疗效.结果:49例53枚消化道宽基底或粗蒂隆起性病变均一次性套扎成功,其中12例同时加行高频电凝切除;术后45例复查37例隆起性病变完全脱落消失(含已电凝切除者),7例部分脱落,1例未脱落;4例失访.1例同时加行高频电凝切除后并创面小动脉出血.治愈37例(82%)、有效7例(16%)、无效1例(2%).结论:尼龙绳套扎法对宽基底或粗蒂消化道隆起性病变的治疗效果满意,是一种安全、有效、经济、操作简便的方法,值得推广. 相似文献
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《Journal of pediatric surgery》2023,58(4):643-647
BackgroundLaparoscopic appendectomy is one of the most common urgent pediatric surgical operations. Endoscopic surgical staplers and pre-tied endoloop ligatures are both routinely used for closure of the appendiceal stump in children. Practice patterns vary for a number of reasons, including cost, size, and ease of use. While stapling is standard for some pediatric surgeons, others believe that staples can act as a nidus for small bowel obstruction (SBO). However, studies comparing closure methods have been conflicting in their results and limited in size. Therefore, we aim to determine if there is an association between appendiceal stump closure method and SBO using a national comparative pediatric database.MethodsWe queried the Pediatric Health Information System (PHIS) for patients ages 3–18 years who underwent laparoscopic appendectomy for appendicitis between 1/1/2016 – 12/31/2020. We included hospitals that had greater than 50 patients with billing data and excluded patients with inflammatory bowel disease and simultaneous abdominal operations. We used billing data for the patient's appendectomy to determine if a stapler or a suture ligature was used during the case. Our primary outcome of interest was post-operative SBO or reoperation for lysis of adhesion or intestinal surgery within the first 30 post-operative days. Multivariable regression analyses were used to estimate the association between stump closure method and post-operative SBO or reoperation in addition to cost while adjusting for patient demographics and appendiceal perforation.ResultsIn total, 49,191 patients from 37 hospitals were included, of which, 29,733 (60.44%) were male, 21,403 (43.51%) were non-Hispanic white, and 18,291 (37.18%) had a diagnosis of complicated appendicitis. The median [IQR] age of the cohort was 11 [8–14] years. A surgical stapler was used during laparoscopic appendectomy in 35,788 (72.75%) patients, and early SBO or reoperation occurred in 653 (1.33%) patients. In adjusted analysis controlling for demographics and complicated appendicitis there was no statistically significant difference in the odds of SBO or reoperation between the two groups. (OR 1.17; 99% CI 0.86 – 1.6). Complicated appendicitis was the factor most associated with post-operative SBO or reoperation (OR 4.4; 99% CI 3.01 – 6.44). Median cumulative cost was slightly higher on unadjusted analysis in the stapler group ($10,329.3 vs $9,569.2). However, there was no significant difference on adjusted analysis.ConclusionSBO or reoperation following laparoscopic appendectomy for appendicitis is uncommon. Complicated appendicitis is the most predictive factor of this outcome. Adjusting for available patient, disease, and hospital characteristics, use of a surgical stapler does not appear to be meaningfully associated with the development of acute SBO or reoperation. Surgeon preference remains the mainstay for safe appendiceal stump closure method.Level of evidenceLevel III.Study typeRetrospective Comparative Study. 相似文献
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Jae Hyun Yoon Chung Hwan Jun Jae Pil Han Ji-Woong Yeom Seung-Ku Kang Hyun Yi Kook Sung Kyu Choi 《World Journal of Clinical Cases》2021,9(5):1228-1236
BACKGROUNDPrimary endoscopic closure of a perforated gastric wall during endoscopic procedures is mostly effective and well-tolerated; however, there are very few studies on the efficacy of endoscopic management of delayed traumatic gastric perforation. Herein, we report a novel case of a patient who was successfully treated for delayed traumatic stomach perforation using an alternative endoscopic modality.CASE SUMMARYA 39-year-old woman presented with multiple penetrating traumas in the back and left abdominal cavity. Initial imaging studies revealed left diaphragmatic disruption and peri-splenic hemorrhage without gastric perforation. An emergency primary repair of the disrupted diaphragm with omental reduction and suturing of the lacerated lung was performed; however, delayed free perforation of the gastric wall was noted on computed tomography after 3 d. Following an emergency abdominal surgery for the primary repair of the gastric wall, re-perforation was noted 15 d postoperatively. The high risk associated with re-surgery prompted an endoscopic intervention using 2 endoloops and 11 endoscopic clips using a novel modified purse-string suture technique. The free perforated gastric wall was successfully repaired without additional surgery or intervention. The patient was discharged after 46 d without any complications.CONCLUSIONEndoscopic closure with endoloops and clips can be a useful therapeutic alternative to re-surgery for delayed traumatic gastric perforation. 相似文献
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Heterotopic pregnancy is defined as the coexistence of an intrauterine and an ectopic pregnancy. The estimated incidence is
one in 30,000 spontaneous pregnancies, with a tenfold increase in women who underwent assisted reproductive technologies.
Diagnosis of a heterotopic pregnancy is often delayed because of the presence of the intrauterine gestational sac. Treatment
of a heterotopic pregnancy should consist of termination of the ectopic pregnancy without damaging the ongoing intrauterine
pregnancy. The least invasive procedure should therefore be used. We present a case of a heterotopic pregnancy consisting
of a viable intrauterine pregnancy and an ectopic cornual pregnancy. Because of the viable intrauterine pregnancy, we decided
to treat the cornual pregnancy laparoscopically by the endoloop technique. This technique is simple, safe, effective and nearly
bloodless. It offers a good prognosis for the ongoing intrauterine pregnancy. 相似文献
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内镜下尼龙绳联合高频电凝切除术治疗结肠巨大息肉临床应用 总被引:2,自引:0,他引:2
目的探讨内镜下尼龙绳套扎联合高频电凝切除术的方法治疗结肠巨大息肉,并评价其安全性和疗效。方法通过内镜检查确诊的30例结肠直径〉2cm的息肉(共30枚),先采取用尼龙绳圈经内镜套扎于息肉的根部,再采取内镜下高频电凝切除术切除,2周后复查内镜。结果本组30例共30枚息肉均套扎成功,并同时进行高频电凝切除术,术后2周复查27例27枚息肉完全脱落消失,3例3枚息肉有蒂端残留,以氩束凝切除,2个月后复查创面修复。本组治疗的治愈率、有效率、无效率分别为90%、10%、0%。所有患者均未见出血、穿孔等并发症。结论内镜下尼龙绳套扎联合高频电凝电切除术治疗结肠巨大息肉的方法安全有效,并发症少。 相似文献
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Samir Delibegovi? Muhamed Katica Ferid Lati? Jasminka Jaki?-Razumovi? Anhel Koluh Mahmoud T. M. Njoum 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2013,17(4):543-548