用腔隙贴合金属支架在 EUS 引导下进行肠造口术,作为恶性肠闭塞的挽救疗法:一项多中心研究。

IF 11.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Endoscopy Pub Date : 2025-01-01 Epub Date: 2024-06-26 DOI:10.1055/a-2354-3352
Benedetto Neri, Serena Stigliano, Dario Biasutto, Nicolò Citterio, Andrea Lisotti, Pietro Fusaroli, Benedetto Mangiavillano, Gianfranco Donatelli, Giuseppe Tonini, Francesco Maria Di Matteo
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引用次数: 0

摘要

背景和研究目的:手术是恶性肠梗阻(MIO)的首选治疗方法,但许多患者被认为不适合手术。内镜超声引导下肠结肠造口术(EUS-EC)和腔内金属支架(LAMS)可能是一种新的治疗选择。首要目标是 EUS-EC 的技术成功率。次要目标:临床结果、安全性、住院时间:回顾性纳入2021年11月至2023年9月期间在欧洲四家三级转诊中心接受EUS-EC治疗MIO的连续患者。所有病例均在多学科会议上讨论,患者被宣布不适合手术、结肠支架置入或拒绝手术:共有 12 名患者入选(58.3% 为女性,中位年龄为 72.5 [42-85])。75%的病例的原发肿瘤为结肠腺癌,91.7%的患者为 IV 期疾病。所有手术均取得了技术成功(100%)。未观察到 LAMS 部署错误或其他手术不良事件,3 例(25%)出现严重的术后并发症。10例(83.3%)患者取得了临床成功,其中5例(50%)在术后恢复了化疗。术后住院时间中位数为9[1-20]天,总生存期中位数为47.5[2-270]天:结论:EUS-EC 是一种可行的技术,对于高度选择性患者,可以考虑将其作为 MIO 标准方法的一种可能替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic ultrasound-guided entero-colostomy with lumen-apposing metal stent as a rescue treatment for malignant intestinal occlusion: a multicenter study.

Background: Surgery is the first-choice treatment for malignant intestinal obstruction (MIO); however, many patients are deemed unfit for surgery. Endoscopic ultrasound-guided entero-colostomy (EUS-EC) with a lumen-apposing metal stent (LAMS) could represent a new treatment option.

Methods: Consecutive patients undergoing EUS-EC for MIO from November 2021 to September 2023 at four European tertiary referral centers were retrospectively enrolled. Multidisciplinary meetings determined whether patients were unsuitable for surgery or colonic stent placement, or refused surgery. The primary outcome was technical success of EUS-EC and secondary outcomes were clinical outcome, safety, and hospital stay.

Results: 12 patients were enrolled (median age 72.5 [range 42-85] years; 58.3% female). Colonic adenocarcinoma was the primary tumor in 75.0% of patients and 91.7% had stage IV disease. Technical success was 100%. No LAMS misdeployment or other procedural adverse events occurred; three patients (25.0%) had severe post-procedural complications. Clinical success was achieved in 10 patients (83.3%), with 5 (50.0%) resuming chemotherapy after the procedure. Median post-procedural hospital stay was 9 (1-20) days and median overall survival was 47.5 (2-270) days.

Conclusions: EUS-EC was a feasible technique and could be considered a possible alternative to standard approaches for MIO in highly selected patients.

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来源期刊
Endoscopy
Endoscopy 医学-外科
CiteScore
5.80
自引率
11.80%
发文量
1401
审稿时长
2 months
期刊介绍: Endoscopy is a leading journal covering the latest technologies and global advancements in gastrointestinal endoscopy. With guidance from an international editorial board, it delivers high-quality content catering to the needs of endoscopists, surgeons, clinicians, and researchers worldwide. Publishing 12 issues each year, Endoscopy offers top-quality review articles, original contributions, prospective studies, surveys of diagnostic and therapeutic advances, and comprehensive coverage of key national and international meetings. Additionally, articles often include supplementary online video content.
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