一次性子镜辅助肠道支架置入术在急性恶性结直肠梗阻中的应用价值（含视频）

Application value of intestinal stent placement assisted by disposable subscope for acute malignant colorectal obstruction (with video)

摘要:

为探讨一次性子镜辅助肠道金属支架置入术在急性恶性结直肠梗阻中的应用价值，回顾性分析2023年6月至2024年7月在扬州大学附属医院消化内镜中心因急性恶性结直肠梗阻行一次性子镜辅助肠道金属支架置入术治疗的患者的临床资料，分析子镜辅助肠道金属支架置入术的技术成功率、临床成功率、手术操作时间、术后并发症以及一期外科手术切除吻合率等。共纳入16例患者，男10例，女6例，年龄（72.19±9.40）岁。8例（50.00%）梗阻位于降结肠，6例（37.50%）位于乙状结肠，1例（6.25%）位于直肠-乙状结肠交界处，1例（6.25%）位于横结肠脾曲。16例患者均成功放置支架，技术成功率100.00%（16/16）。1例（6.25%）患者放置支架后梗阻症状未缓解，临床成功率为93.75%（15/16）。16例患者的内镜手术操作时间为（37.8±13.9）min。所有患者术后无出血、穿孔及支架移位或脱落情况。 16例患者中有14例后续行外科手术治疗，一期外科手术切除吻合率为71.43%（10/14）。本研究初步认为基于一次性子镜辅助下肠道金属支架置入术治疗急性恶性结直肠梗阻安全有效，且无辐射。

Abstract:

To investigate the application value of disposable subscope‑assisted intestinal metal stent placement in the treatment for acute malignant colorectal obstruction, a retrospective analysis was conducted on the patients who underwent intestinal metal stent placement assisted by disposable subscope for acute malignant colorectal obstruction at the Digestive Endoscopy Center, Affiliated Hospital of Yangzhou University from June 2023 to July 2024. The technical success rate, clinical success rate, operation time, postoperative complications and first‑stage surgical resection anastomosis rate of intestinal metal stent placement assisted by subscope were analyzed. Among the 16 included patients, there were 10 males and 6 females, with the age of 72.19±9.40 years. Obstruction occurred at the descending colon in 8 cases (50.00%), at the sigmoid colon in 6 cases (37.50%), at the rectosigmoid junction in 1 case (6.25%), and at the splenic flexure of the transverse colon in 1 case (6.25%). All 16 patients successfully underwent stent placement, with a technical success rate of 100.00% (16/16). Obstruction symptoms did not relieve in one patient (6.25%) after stent placement, resulting in a clinical success rate of 93.75% (15/16). The endoscopic operation time for the 16 patients was 37.8±13.9 minutes. No bleeding, perforation, stent displacement, or detachment occurred after the operation. Fourteen patients underwent subsequent surgical treatment, the first‑stage surgical resection anastomosis rate was 71.43% (10/14). This preliminary study suggests that the disposable subscope‑assisted intestinal metal stent placement for the treatment of acute malignant colorectal obstruction is safe and effective, with no radiation exposure.