经鼻型肠梗阻导管置入联合腹腔镜治疗回盲部恶性肠梗阻

Placement of transnasal ileus tube combined with laparoscopy in the treatment of ileocecal malignant intestinal obstruction

目的探讨X线透视下经鼻型肠梗阻导管置入联合腹腔镜治疗回盲部恶性肠梗阻的可行性、安全性、有效性。方法选取我院收治的24例X线透视下经鼻型肠梗阻导管置入的回盲部恶性梗阻患者临床资料。评估肠梗阻导管置入技术成功率、相关并发症发生率、置管后48 h患者临床症状缓解率,肠道减压后患者择期行腹腔镜一期肿瘤切除肠吻合术后随访,评估术后并发症发生率。结果24例患者行经鼻型肠梗阻导管置入,技术成功率100%(24/24),临床症状缓解率100%(24/24),无置管相关并发症发生,腹腔镜术中见肠壁无明显充血、水肿,术后无切口感染、吻合口出血、吻合口瘘并发症发生。结论经鼻型肠梗阻导管置入联合腹腔镜治疗回盲部恶性肠梗阻可行、安全、有效,值得临床推广应用。

Objective To investigate the feasibility,safety and effectiveness of placement of transnasal ileus tube underline X-ray combined with laparoscopy in the treatment of ileocecal malignant intestinal obstruction.Methods Clinical data of 24 patients with acute ileocecal malignant obstruction who received placement of transnasal ileus tube underline X-ray in our hospital were retrospectively analyzed.The technical success rate,the incidence of related complications,clinical success rate within 48 h was evaluated.Primary resection and anastomosis were performed after intestinal depression.Followed 1 month after laparoscopy,the incidence of postoperative complications was evaluated.Results 24 patients underwent placement of transnasal ileus tube.The technical success rate was 100%(24/24),and the clinical symptom relief rate was 100.00%(24/24).There was no complications related to the catheterization.The intestinal wall was seen during laparoscopy.There were no obvious congestion and edema,and there were no complications of incision infection,anastomotic bleeding,and anastomotic fistula.Conclusion Placement of transnasal ileus tube combined with laparoscopy in the treatment of ileocecal malignant intestinal obstruction is feasible,safe and effective,which is worthy of clinical application.