双镜联合精准穿刺引导扩张治疗结直肠癌术后吻合口闭锁初探（含视频）

Preliminary study of dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery (with video)

摘要:

为评估双软式内镜联合精准穿刺引导扩张治疗结直肠癌术后吻合口闭锁的可行性与安全性，对3例结直肠癌术后吻合口闭锁病例进行内镜引导下的精准治疗。首先使用结肠镜从回肠末端造口进镜至吻合口处，另一条内镜经肛门进镜至吻合口，通过光源定位精准穿刺对侧肠腔，内镜直视下见穿刺针针头，然后置入导丝，循导丝引导球囊扩张吻合口。3例患者均顺利完成吻合口闭锁内镜下再通治疗，治疗过程中无并发症发生，平均用时44.3 min，内镜治疗后1~3个月内行回肠末端造口还纳手术，均恢复顺利。双镜联合精准穿刺引导扩张治疗结直肠癌术后吻合口闭锁技术经随访观察效果可靠，具有操作时间短、安全简便、无需X线辅助等优点。

Abstract:

To evaluate the feasibility and safety of dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery, 3 cases with anastomotic atresia after colorectal cancer surgery were treated precisely under endoscopy. The first colonoscopy was introduced through the terminal ileum stoma to anastomotic site, another endoscope was inserted through the anus to the anastomosis. Precise puncture of the contralateral intestinal cavity was done through light source positioning. The puncture needle was seen under the direct vision of endoscope, and then the guide wire was inserted. Anastomosis was dilated by the balloon through the guide wire. Endoscopic recanalization of anastomotic atresia was successfully completed in 3 patients. No complication occurred during the treatment with the mean operation time of 44.3 minutes. The ileal terminal stoma reduction surgery was performed 1-3 months after endoscopic treatment. Dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery is reliable with the advantages of short operation time, safety and convenience, and no need for X-ray assistance.