支架造瘘:内镜下支架置入治疗难治性小肠瘘。

IF 2.5 3区 医学 Q1 SURGERY
Marcus Kantowski, Peter Sauer, Michael Ardelt, Nathaniel Melling, Thomas Roesch, Chengcheng Christine Zhang
{"title":"支架造瘘:内镜下支架置入治疗难治性小肠瘘。","authors":"Marcus Kantowski, Peter Sauer, Michael Ardelt, Nathaniel Melling, Thomas Roesch, Chengcheng Christine Zhang","doi":"10.1177/14574969241310051","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>The therapeutic management of fistulas presents significant challenges, often involving both conservative and surgical approaches. Despite these interventions, recurrence and postoperative mortality rates remain high. Endoscopic stent insertion into the fistula, along with the creation of a stent stoma, may offer a promising alternative for patients who fail surgical or conservative therapies. This study aimed to evaluate the feasibility, effectiveness, and safety of endoscopic stent insertion in the treatment of refractory small intestinal fistulas.</p><p><strong>Methods: </strong>Patients with refractory small intestine fistulas who underwent endoscopic stent insertion were included. The primary endpoint was defined as successful fistula treatment, which included an improvement in clinical symptoms related to the fistula, successful bridging to subsequent surgical revision, and the restoration of enteral nutrition. Secondary endpoints comprised the feasibility of the endoscopic procedure, complications, procedure-related complications, and in-hospital mortality.</p><p><strong>Results: </strong>Eight patients were included, with a median follow-up period of 2.7 months. The implantation of a self-expanding metal stent was successfully performed in all patients (technical success rate, 100%; <i>n</i> = 8/8). The clinical success rate was 87.5% (<i>n</i> = 7/8), indicating clinical improvement in fistula-related symptoms, wound care, and enteral nutrition. Procedure-related complications occurred in one patient (12.5%; <i>n</i> = 1/8), involving stent dislocation leading to small intestine perforation, which was managed endoscopically. No procedure-related mortality was observed.</p><p><strong>Conclusions: </strong>Endoscopic stent insertion is a feasible, effective, and safe option for the management of therapy-refractory small intestinal fistulas. The creation of a stent stoma improves patient quality of life.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969241310051"},"PeriodicalIF":2.5000,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stent stoma: Endoscopic stent insertion for refractory small intestine fistulas.\",\"authors\":\"Marcus Kantowski, Peter Sauer, Michael Ardelt, Nathaniel Melling, Thomas Roesch, Chengcheng Christine Zhang\",\"doi\":\"10.1177/14574969241310051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>The therapeutic management of fistulas presents significant challenges, often involving both conservative and surgical approaches. Despite these interventions, recurrence and postoperative mortality rates remain high. Endoscopic stent insertion into the fistula, along with the creation of a stent stoma, may offer a promising alternative for patients who fail surgical or conservative therapies. This study aimed to evaluate the feasibility, effectiveness, and safety of endoscopic stent insertion in the treatment of refractory small intestinal fistulas.</p><p><strong>Methods: </strong>Patients with refractory small intestine fistulas who underwent endoscopic stent insertion were included. The primary endpoint was defined as successful fistula treatment, which included an improvement in clinical symptoms related to the fistula, successful bridging to subsequent surgical revision, and the restoration of enteral nutrition. Secondary endpoints comprised the feasibility of the endoscopic procedure, complications, procedure-related complications, and in-hospital mortality.</p><p><strong>Results: </strong>Eight patients were included, with a median follow-up period of 2.7 months. The implantation of a self-expanding metal stent was successfully performed in all patients (technical success rate, 100%; <i>n</i> = 8/8). The clinical success rate was 87.5% (<i>n</i> = 7/8), indicating clinical improvement in fistula-related symptoms, wound care, and enteral nutrition. Procedure-related complications occurred in one patient (12.5%; <i>n</i> = 1/8), involving stent dislocation leading to small intestine perforation, which was managed endoscopically. No procedure-related mortality was observed.</p><p><strong>Conclusions: </strong>Endoscopic stent insertion is a feasible, effective, and safe option for the management of therapy-refractory small intestinal fistulas. The creation of a stent stoma improves patient quality of life.</p>\",\"PeriodicalId\":49566,\"journal\":{\"name\":\"Scandinavian Journal of Surgery\",\"volume\":\" \",\"pages\":\"14574969241310051\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-01-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/14574969241310051\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/14574969241310051","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

摘要

背景和目的:瘘管的治疗管理提出了重大挑战,通常涉及保守和手术方法。尽管采取了这些干预措施,复发率和术后死亡率仍然很高。内窥镜支架置入瘘管,同时创建一个支架造口,可能为手术或保守治疗失败的患者提供一个有希望的选择。本研究旨在评估内镜下支架置入治疗难治性小肠瘘的可行性、有效性和安全性。方法:对难治性小肠瘘行内镜下支架置入的患者进行分析。主要终点被定义为瘘管治疗的成功,包括与瘘管相关的临床症状的改善,成功地与随后的手术翻修相衔接,以及肠内营养的恢复。次要终点包括内镜手术的可行性、并发症、手术相关并发症和住院死亡率。结果:纳入8例患者,中位随访时间为2.7个月。所有患者均成功植入自膨胀金属支架(技术成功率100%;n = 8/8)。临床成功率为87.5% (n = 7/8),表明瘘相关症状、伤口护理和肠内营养的临床改善。1例患者发生手术相关并发症(12.5%;N = 1/8),包括支架脱位导致小肠穿孔,经内镜处理。未观察到手术相关的死亡率。结论:内镜下支架置入术是治疗难治性小肠瘘的一种可行、有效、安全的选择。支架造口提高了患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stent stoma: Endoscopic stent insertion for refractory small intestine fistulas.

Background and aims: The therapeutic management of fistulas presents significant challenges, often involving both conservative and surgical approaches. Despite these interventions, recurrence and postoperative mortality rates remain high. Endoscopic stent insertion into the fistula, along with the creation of a stent stoma, may offer a promising alternative for patients who fail surgical or conservative therapies. This study aimed to evaluate the feasibility, effectiveness, and safety of endoscopic stent insertion in the treatment of refractory small intestinal fistulas.

Methods: Patients with refractory small intestine fistulas who underwent endoscopic stent insertion were included. The primary endpoint was defined as successful fistula treatment, which included an improvement in clinical symptoms related to the fistula, successful bridging to subsequent surgical revision, and the restoration of enteral nutrition. Secondary endpoints comprised the feasibility of the endoscopic procedure, complications, procedure-related complications, and in-hospital mortality.

Results: Eight patients were included, with a median follow-up period of 2.7 months. The implantation of a self-expanding metal stent was successfully performed in all patients (technical success rate, 100%; n = 8/8). The clinical success rate was 87.5% (n = 7/8), indicating clinical improvement in fistula-related symptoms, wound care, and enteral nutrition. Procedure-related complications occurred in one patient (12.5%; n = 1/8), involving stent dislocation leading to small intestine perforation, which was managed endoscopically. No procedure-related mortality was observed.

Conclusions: Endoscopic stent insertion is a feasible, effective, and safe option for the management of therapy-refractory small intestinal fistulas. The creation of a stent stoma improves patient quality of life.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.50
自引率
4.20%
发文量
37
审稿时长
6-12 weeks
期刊介绍: The Scandinavian Journal of Surgery (SJS) is the official peer reviewed journal of the Finnish Surgical Society and the Scandinavian Surgical Society. It publishes original and review articles from all surgical fields and specialties to reflect the interests of our diverse and international readership that consists of surgeons from all specialties and continents.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信