内镜下放射状切开治疗结直肠吻合口良性闭锁及狭窄的疗效

Endoscopic radial incision in the treatment of benign atresia and stenosis of colorectal anastomosis

目的探讨经内镜下放射状切开术治疗结直肠吻合口良性狭窄及闭锁中的疗效。方法选取结直肠术后吻合口良性狭窄及闭锁的患者25例,均采用内镜下放射状切开术治疗,操作均为同一科室医师用相同方法完成,对患者治疗效果及术中、术后并发症及复发率进行观察,随访评估梗阻症状及吻合口狭窄复发情况。结果入组25例患者中,25例(100.0%)治疗成功,操作时间14~42 min,平均18.7 min;住院天数3~7 d,平均4 d。术前吻合口直径为0~10 mm,平均(6.67±2.48)mm;术后吻合口直径扩张至14~18 mm,平均(16.17±1.27)mm;6个月后吻合口直径为13~15 mm,平均(15.29±1.04)mm,差异有统计学意义(P<0.05)。随访期间患者均未出现肠道梗阻症状及吻合口狭窄复发。结论经内镜下放射状切开术在治疗结直肠术后良性吻合口狭窄中安全、有效。

Objective To investigate the effect of endoscopic radial incision in the treatment of benign colorectal anastomotic stenosis.Methods Twenty-five patients with benign anastomotic stenosis and atresia after colorectal surgery were selected from January 2018 to December 2020.All patients were treated with endoscopic radial incision for benign colorectal anastomotic stenosis.The operation was performed by same doctors with same method.The effect,intraoperative and postoperative complications about endoscopic radial incision and the recurrence rate of anastomotic stenosis were observed.The patients were followed up to evaluate the obstruction symptoms and recurrence of anastomotic stenosis.Results Twenty-five patients(100.0%)were treated successfully.The operation time was 14-42 minutes and the average time was 18.7 minutes;the hospital stay was 3-7 days and the average time was 4 days.The preoperative diameter of anastomotic astium was 0-10 mm,the average of diameter was(6.67±2.48)mm;the postoperative diameter of ones was 14-18 mm,the average of diameter was(16.17±1.27)mm;the postoperative diameter of ones at six months after surgery was 13-15 mm,the average of diameter was(15.29±1.04)mm.There was statistically significant difference of diameter between preoperation and postoperation(P<0.05).Conclusions Endoscopic radial incision is a safe and effective method in the treatment of benign anastomotic stenosis after colorectal surgery.