Acute obstructing left-sided colonic lesions: Role of preoperative endoscopic colonic stent insertion

Wael Al-shelfa, M. Marie, A. Hashem, Shymaa Yahia, S. Mansour, S. Saddick, A. Ibrahim
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Abstract

Background: Malignant obstruction due to left-sided colonic malignant lesions is an acute emergent situation which is always dealt with by emergent celiotomy and colostomy for salvage of patient life. Colostomy is considered life-saving in such situations, yet it is of undesirable psychological feedback impressions for patients. The aim of this work is to describe our experience with the use of colonic stent in left-sided malignant obstruction, as a good step to relieve the obstruction, and hence to proceed for one-step resection anastomosis with primary repair without the need for colostomy, which is in itself of good impact for psychological satisfaction and salvage of patient. Patients and Methods: Out of 20 patients with left-sided colonic obstruction, 9 patients were dealt with colonic stent, of them 7 patients had one-step procedure with either left hemicolectomy or sigmoidectomy, and 11 had emergent surgical interference with colostomy. Results: Seven of nine patients had a successful laparoscopic colonic stent, and followed by a successful one-step surgical procedure, two of nine patients had unsuccessful laparoscopic stent with emergent exploration and colostomy. Conclusion: Colonic stent for the left malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.
急性左半结肠阻塞病变:术前内镜下结肠支架置入的作用
背景:左侧结肠恶性病变引起的恶性梗阻是一种急症,通常采用紧急切腹造口术来挽救患者的生命。在这种情况下,结肠造口术被认为是挽救生命的,但它给患者带来了不良的心理反馈印象。本工作的目的是描述我们在左侧恶性梗阻中使用结肠支架的经验,作为缓解梗阻的一个很好的步骤,因此无需结肠造口即可进行一步切除吻合一期修复,这本身对患者的心理满足和抢救有很好的影响。患者与方法:20例左侧结肠梗阻患者中,9例行结肠支架置换术,其中7例行左结肠半切除术或乙状结肠切除术,11例行紧急结肠造口手术干预。结果:9例患者中有7例成功植入腹腔镜结肠支架,随后进行了成功的一步外科手术,9例患者中有2例不成功的腹腔镜支架需要紧急探查和结肠造口。结论:结肠支架治疗左侧恶性梗阻是一种有价值的手术方法,可一步切除,一期吻合,无需结肠造口。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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