结肠支架植入术作为手术治疗阻塞性结直肠癌的桥梁。

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY Clinical Endoscopy Pub Date : 2024-07-01 Epub Date: 2024-03-08 DOI:10.5946/ce.2023.138
Dong Hyun Kim, Han Hee Lee
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引用次数: 0

摘要

结肠支架置入术是阻塞性结肠直肠癌患者手术中常用的桥接策略。该手术包括在梗阻病灶处放置自膨胀金属支架(SEMS),以恢复肠道通畅并缓解梗阻症状。通过让患者有时间进行术前优化和肠道准备,有计划、分阶段地接受手术,支架置入术可减少对紧急手术的需求,而紧急手术与较高的并发症发生率和较差的治疗效果相关。本综述将重点讨论结肠支架置入术作为手术治疗梗阻性结直肠癌的桥梁所发挥的作用。已证实 SEMS 作为左侧结肠癌手术的桥梁特别有用;但对于右侧结肠癌病例的应用还需要进一步研究。结肠支架置入术也存在局限性和潜在并发症,包括支架移位、再梗阻和穿孔。然而,SEMS 置入后进行根治性手术的时机仍无定论。考虑到迄今为止的文献资料,间隔约两周进行手术被认为是合适的。因此,结肠支架置入术可能是阻塞性结直肠癌患者进行手术的有效策略。
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Colon stenting as a bridge to surgery in obstructive colorectal cancer management.

Colonic stent placement is a commonly used bridging strategy for surgery in patients with obstructive colorectal cancer. The procedure involves the placement of a self-expandable metallic stent (SEMS) across the obstructive lesion to restore intestinal patency and alleviate the symptoms of obstruction. By allowing patients to receive surgery in a planned and staged manner with time for preoperative optimization and bowel preparation, stent placement may reduce the need for emergency surgery, which is associated with higher complication rates and poorer outcomes. This review focuses on the role of colon stenting as a bridge to surgery in the management of obstructive colorectal cancer. SEMS as a bridge to surgery for left-sided colon cancer has been demonstrated to be particularly useful; however, further research is needed for its application in cases of right-sided colon cancer. Colon stent placement also has limitations and potential complications including stent migration, re-obstruction, and perforation. However, the timing of curative surgery after SEMS placement remains inconclusive. Considering the literature to date, performing surgery at an interval of approximately 2 weeks is considered appropriate. Therefore, colonic stent placement may be an effective strategy as a bridge to surgery in patients with obstructive colorectal cancer.

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来源期刊
Clinical Endoscopy
Clinical Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
8.00%
发文量
95
审稿时长
26 weeks
期刊最新文献
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