经内镜放射状切开术在治疗结直肠吻合口良性狭窄中的临床应用

Clinical application of endoscopic radial incision in treatment of benign stenosis of colorectal anastomosis

目的探讨经内镜下放射状切开术在治疗结直肠吻合口良性狭窄中的有效性和安全性.方法选取2015年1月-2016年12月该院结直肠术后并吻合口良性狭窄的患者46例,均采用内镜下放射状切开术解除肠道狭窄,操作为同一内镜医生完成,对患者治疗效果及术中、术后并发症进行总结,并随访1年,评估梗阻症状及吻合口狭窄复发情况.结果①入组46例患者中,45例(97.8%)治疗成功,操作时间12~36 min(平均18 min),住院天数2~6 d(平均3 d);②完成治疗的45例(100.0%)患者肠道梗阻症状均得到明显改善;③术中、术后均未出现穿孔、感染及严重的出血、腹痛等并发症;④41例(91.1%)患者完成随访,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吻合口良性狭窄中安全、有效,值得临床推广应用.

Objective To discuss the method and clinical application value of endoscopic radial incision in treatment of benign stenosis of colorectal anastomosis. Methods 46 patients with anastomotic stenosis underwent colorectal surgery from January 2015 to December 2016 were enrolled in the study, all the patients were adopted endoscopic radial incision to remove intestinal stricture, and all the operations were completed by the same doctor, treatment effect, intra-operative and postoperative complications were summarized, and followed up for 1 year, the symptoms of obstruction and anastomotic stenosis recurrence were assessed. Results 45 (97.8%) patients were successfully treated, the operation time was 18 (12 ~ 36) min, and the hospitalization days were 3 (2 ~ 6) d. The symptoms of intestinal obstruction were significantly improved in all the 45 patients (100.0%) who completed the treatment. There were no complications (0.0%) during or post-operation, such as bleeding, perforation or abdominal pain. 41 (91.1%) patients completed followed-up, and no symptoms of obstruction or anastomotic stenosis recurrence occurred during the follow-up period. Conclusion It is safe and effective for endoscopic radial incision in treatment of benign stenosis of colorectal anastomosis, and it is worthy to promote clinically.