炎症性肠病狭窄、瘘和脓肿内镜治疗的系统评价

IF 0.7 Q3 GASTROENTEROLOGY & HEPATOLOGY
P. Pal, Swathi Kanaganti, R. Banerjee, M. Ramchandani, Z. Nabi, D. Reddy, M. Tandan
{"title":"炎症性肠病狭窄、瘘和脓肿内镜治疗的系统评价","authors":"P. Pal, Swathi Kanaganti, R. Banerjee, M. Ramchandani, Z. Nabi, D. Reddy, M. Tandan","doi":"10.3390/gastroent14010006","DOIUrl":null,"url":null,"abstract":"Background: Interventional inflammatory bowel disease (IIBD) therapies can play a key role in inflammatory bowel disease (IBD) related stricture/fistula/abscess deferring or avoiding invasive surgery. Methods: A total of 112 studies pertaining to IIBD therapy for strictures/fistula/abscess between 2002 and December 2022 were included by searching Pubmed, Medline and Embase with a focus on technical/clinical success, recurrence, re-intervention and complications. Results: IIBD therapy for strictures include endoscopic balloon dilation (EBD), endoscopic stricturotomy (ES) and self-expanding metal stent (SEMS) placement. EBD is the primary therapy for short strictures while ES and SEMS can be used for refractory strictures. ES has higher long-term efficacy than EBD. SEMS is inferior to EBD although it can be useful in long, refractory strictures. Fistula therapy includes endoscopic incision and drainage (perianal fistula)/endoscopic seton (simple, low fistula) and endoscopic ultrasound-guided drainage (pelvic abscess). Fistulotomy can be done for short, superficial, single tract, bowel-bowel fistula. Endoscopic injection of filling agents (fistula plug/glue/stem cell) is feasible although durability is unknown. Endoscopic closure therapies like over-the-scope clips (OTSC), suturing and SEMS should be avoided for de-novo/bowel to hollow organ fistulas. Conclusion: IIBD therapies have the potential to act as a bridge between medical and surgical therapy for properly selected IBD-related stricture/fistula/abscess although future controlled studies are warranted.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Systematic Review of Endoscopic Management of Stricture, Fistula and Abscess in Inflammatory Bowel Disease\",\"authors\":\"P. Pal, Swathi Kanaganti, R. Banerjee, M. Ramchandani, Z. Nabi, D. Reddy, M. Tandan\",\"doi\":\"10.3390/gastroent14010006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Interventional inflammatory bowel disease (IIBD) therapies can play a key role in inflammatory bowel disease (IBD) related stricture/fistula/abscess deferring or avoiding invasive surgery. Methods: A total of 112 studies pertaining to IIBD therapy for strictures/fistula/abscess between 2002 and December 2022 were included by searching Pubmed, Medline and Embase with a focus on technical/clinical success, recurrence, re-intervention and complications. Results: IIBD therapy for strictures include endoscopic balloon dilation (EBD), endoscopic stricturotomy (ES) and self-expanding metal stent (SEMS) placement. EBD is the primary therapy for short strictures while ES and SEMS can be used for refractory strictures. ES has higher long-term efficacy than EBD. SEMS is inferior to EBD although it can be useful in long, refractory strictures. Fistula therapy includes endoscopic incision and drainage (perianal fistula)/endoscopic seton (simple, low fistula) and endoscopic ultrasound-guided drainage (pelvic abscess). Fistulotomy can be done for short, superficial, single tract, bowel-bowel fistula. Endoscopic injection of filling agents (fistula plug/glue/stem cell) is feasible although durability is unknown. Endoscopic closure therapies like over-the-scope clips (OTSC), suturing and SEMS should be avoided for de-novo/bowel to hollow organ fistulas. Conclusion: IIBD therapies have the potential to act as a bridge between medical and surgical therapy for properly selected IBD-related stricture/fistula/abscess although future controlled studies are warranted.\",\"PeriodicalId\":43586,\"journal\":{\"name\":\"Gastroenterology Insights\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2023-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology Insights\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3390/gastroent14010006\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Insights","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/gastroent14010006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 1

摘要

背景:介入性炎症性肠病(IIBD)治疗可以在炎症性肠病(IBD)相关狭窄/瘘/脓肿延迟或避免侵入性手术中发挥关键作用。方法:通过检索Pubmed, Medline和Embase,纳入2002年至2022年12月期间有关IIBD治疗狭窄/瘘管/脓肿的112项研究,重点关注技术/临床成功,复发,再干预和并发症。结果:IIBD治疗狭窄包括内镜下球囊扩张(EBD)、内镜下狭窄切开术(ES)和自膨胀金属支架(SEMS)置入。EBD是短期狭窄的主要治疗方法,而ES和SEMS可用于难治性狭窄。ES的远期疗效高于EBD。SEMS不如EBD,尽管它可以用于长,难治的狭窄。瘘管治疗包括内镜下切开引流(肛周瘘)/内镜下缝合(简单、低瘘)和内镜下超声引导引流(盆腔脓肿)。瘘管切开术可用于短的、浅表的、单道的肠瘘。内镜下注射填充剂(瘘管塞/胶/干细胞)是可行的,但耐久性尚不清楚。对于新生/肠至空心器官瘘管,应避免使用镜外夹(OTSC)、缝合和SEMS等内镜闭合疗法。结论:IIBD治疗有可能作为药物和手术治疗之间的桥梁,适当选择ibd相关的狭窄/瘘/脓肿,尽管未来的对照研究是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic Review of Endoscopic Management of Stricture, Fistula and Abscess in Inflammatory Bowel Disease
Background: Interventional inflammatory bowel disease (IIBD) therapies can play a key role in inflammatory bowel disease (IBD) related stricture/fistula/abscess deferring or avoiding invasive surgery. Methods: A total of 112 studies pertaining to IIBD therapy for strictures/fistula/abscess between 2002 and December 2022 were included by searching Pubmed, Medline and Embase with a focus on technical/clinical success, recurrence, re-intervention and complications. Results: IIBD therapy for strictures include endoscopic balloon dilation (EBD), endoscopic stricturotomy (ES) and self-expanding metal stent (SEMS) placement. EBD is the primary therapy for short strictures while ES and SEMS can be used for refractory strictures. ES has higher long-term efficacy than EBD. SEMS is inferior to EBD although it can be useful in long, refractory strictures. Fistula therapy includes endoscopic incision and drainage (perianal fistula)/endoscopic seton (simple, low fistula) and endoscopic ultrasound-guided drainage (pelvic abscess). Fistulotomy can be done for short, superficial, single tract, bowel-bowel fistula. Endoscopic injection of filling agents (fistula plug/glue/stem cell) is feasible although durability is unknown. Endoscopic closure therapies like over-the-scope clips (OTSC), suturing and SEMS should be avoided for de-novo/bowel to hollow organ fistulas. Conclusion: IIBD therapies have the potential to act as a bridge between medical and surgical therapy for properly selected IBD-related stricture/fistula/abscess although future controlled studies are warranted.
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
Gastroenterology Insights
Gastroenterology Insights GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
3.40%
发文量
35
审稿时长
10 weeks
×
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:604180095
Book学术官方微信