AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METH...AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METHODS:En-DCRs were performed on 44 chronic dacryocystitis patients(46 eyes)secondary to NDS incarceration from April 2016 to October 2022.The granuloma and scar tissues were separated,and the removal of NDS incarceration was achieved during the surgery;the flap of the lacrimal sac was trimmed and anastomosed with nasal mucosal,a bicanalicular silicone tube was implanted,and lacrimal size and condition were assessed.The tube was removed 3mo after surgery.During the final follow-up of 12mo when the surgery was completed,the complications and the rates of surgical success were assessed.RESULTS:This study covered 40 patients(42 eyes).Intraoperatively,it was found that the lacrimal sac became small,and the sac wall had granulation and scar tissue attached to the incarcerated NDS in all eyes.At 12mo after surgery completed,the rates of the functional and anatomical success reached 80.95%(34/42)and 83.33%(35/42),respectively.Under the effect of intranasal ostial closure,seven eyes failed to achieve anatomical success.No serious complications(e.g.,visual impairment,sinusitis,and orbital fat prolapse)was observed.CONCLUSION:With the success rate over 80%and no serious complications,En-DCR with bicanalicular silicone tube implantation is effective in treating chronic dacryocystitis secondary to NDS incarceration.展开更多
BACKGROUND Stent insertion can effective alleviate the symptoms of benign esophageal strictures(BES).Magnesium alloy stents are a good candidate because of biological safety,but show a poor corrosion resistance and a ...BACKGROUND Stent insertion can effective alleviate the symptoms of benign esophageal strictures(BES).Magnesium alloy stents are a good candidate because of biological safety,but show a poor corrosion resistance and a quick loss of mechanical support in vivo.AIM To test the therapeutic and adverse effects of a silicone-covered magnesium alloy biodegradable esophageal stent.METHODS Fifteen rabbits underwent silicone-covered biodegradable magnesium stent insertion into the benign esophageal stricture under fluoroscopic guidance(stent group).The wall reconstruction and tissue reaction of stenotic esophagus in the stent group were compared with those of six esophageal stricture models(control group).Esophagography was performed at 1,2,and 3 weeks.Four,six,and five rabbits in the stent group and two rabbits in the control groups were euthanized,respectively,at each time point for histological examination.RESULTS All stent insertions were well tolerated.The esophageal diameters at immediately,1,2 and 3 wk were 9.8±0.3 mm,9.7±0.7 mm,9.4±0.8 mm,and 9.2±0.5 mm,respectively(vs 4.9±0.3 mm before stent insertion;P<0.05).Magnesium stents migrated in eight rabbits[one at 1 wk(1/15),three at 2 wk(3/11),and four at 3 wk(4/5)].Esophageal wall remodeling(thinner epithelial and smooth muscle layers)was found significantly thinner in the stent group than in the control group(P<0.05).Esophageal injury and collagen deposition following stent insertion were similar and did not differ compared to rabbits with esophageal stricture and normal rabbits(P>0.05).CONCLUSION Esophageal silicone-covered biodegradable magnesium stent insertion is feasible for BES without causing severe injury or tissue reaction.Our study suggests that insertion of silicone-covered magnesium esophageal stent is a promising approach for treating BES.展开更多
A 67-year-old man had a sev-ere cough and pulmonary infection for 1 wk before seeking evaluation at our hospital.He had undergone esophagectomy with gastric pull-up and radiotherapy for esophageal cancer 3 years previ...A 67-year-old man had a sev-ere cough and pulmonary infection for 1 wk before seeking evaluation at our hospital.He had undergone esophagectomy with gastric pull-up and radiotherapy for esophageal cancer 3 years previously.After admission to our hospital,gastroscopy and bronchoscopy revealed a fistulous communication between the posterior tracheal wallnear the carina and the upper residual stomach.We measured the diameter of the trachea and bronchus and determined the site and size of the fistula using multislice computed tomography and gastroscopy.A covered self-expanding Y-shaped metallic stent was implanted into the trachea and bronchus.Subsequently,the fistula was closed completely.The patient tolerated the stent well and had good palliation of his symptoms.展开更多
目的：初步探讨 Y 型硅酮气道支架置入治疗气管下段、气管隆突、双主支气和气管食管瘘等复合病变的可行性和疗效。方法根据气道复合病变的特殊解剖结构，设计并裁剪气道 Y 型硅酮支架，在全麻硬质支气管镜引导下，对7例气道复合病变患...目的：初步探讨 Y 型硅酮气道支架置入治疗气管下段、气管隆突、双主支气和气管食管瘘等复合病变的可行性和疗效。方法根据气道复合病变的特殊解剖结构，设计并裁剪气道 Y 型硅酮支架，在全麻硬质支气管镜引导下，对7例气道复合病变患者置入 Y 型硅酮支架7枚。结果 Y 型硅酮支架均一次性置入成功，7例患者置入内支架后症状均缓解，呼吸困难分级由Ⅲ～Ⅳ级改善为0～Ⅱ级，脉搏血氧饱和度（SpO2）高流量吸氧时的77.0%～90.0%[平均为（84.1±4.5）%]提高至自然呼吸时的90.0%～99.0%[平均为（94.1±2.9）%]，与术前比较差异有统计学意义（P =0.000），主要并发症为咳嗽、异物感、胸痛、肉芽形成和痰液潴留。结论气道 Y 型硅酮支架置入能有效解除气道复合病变，技术可行，操作相对简单、安全，近期疗效可靠，值得进一步推广应用。展开更多
文摘AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METHODS:En-DCRs were performed on 44 chronic dacryocystitis patients(46 eyes)secondary to NDS incarceration from April 2016 to October 2022.The granuloma and scar tissues were separated,and the removal of NDS incarceration was achieved during the surgery;the flap of the lacrimal sac was trimmed and anastomosed with nasal mucosal,a bicanalicular silicone tube was implanted,and lacrimal size and condition were assessed.The tube was removed 3mo after surgery.During the final follow-up of 12mo when the surgery was completed,the complications and the rates of surgical success were assessed.RESULTS:This study covered 40 patients(42 eyes).Intraoperatively,it was found that the lacrimal sac became small,and the sac wall had granulation and scar tissue attached to the incarcerated NDS in all eyes.At 12mo after surgery completed,the rates of the functional and anatomical success reached 80.95%(34/42)and 83.33%(35/42),respectively.Under the effect of intranasal ostial closure,seven eyes failed to achieve anatomical success.No serious complications(e.g.,visual impairment,sinusitis,and orbital fat prolapse)was observed.CONCLUSION:With the success rate over 80%and no serious complications,En-DCR with bicanalicular silicone tube implantation is effective in treating chronic dacryocystitis secondary to NDS incarceration.
基金Supported by the National Natural Science Foundation of China,No.81371659,No.81571773,and No.81771943Shanghai Municipal Health and Family Planning Commission,No.201640191
文摘BACKGROUND Stent insertion can effective alleviate the symptoms of benign esophageal strictures(BES).Magnesium alloy stents are a good candidate because of biological safety,but show a poor corrosion resistance and a quick loss of mechanical support in vivo.AIM To test the therapeutic and adverse effects of a silicone-covered magnesium alloy biodegradable esophageal stent.METHODS Fifteen rabbits underwent silicone-covered biodegradable magnesium stent insertion into the benign esophageal stricture under fluoroscopic guidance(stent group).The wall reconstruction and tissue reaction of stenotic esophagus in the stent group were compared with those of six esophageal stricture models(control group).Esophagography was performed at 1,2,and 3 weeks.Four,six,and five rabbits in the stent group and two rabbits in the control groups were euthanized,respectively,at each time point for histological examination.RESULTS All stent insertions were well tolerated.The esophageal diameters at immediately,1,2 and 3 wk were 9.8±0.3 mm,9.7±0.7 mm,9.4±0.8 mm,and 9.2±0.5 mm,respectively(vs 4.9±0.3 mm before stent insertion;P<0.05).Magnesium stents migrated in eight rabbits[one at 1 wk(1/15),three at 2 wk(3/11),and four at 3 wk(4/5)].Esophageal wall remodeling(thinner epithelial and smooth muscle layers)was found significantly thinner in the stent group than in the control group(P<0.05).Esophageal injury and collagen deposition following stent insertion were similar and did not differ compared to rabbits with esophageal stricture and normal rabbits(P>0.05).CONCLUSION Esophageal silicone-covered biodegradable magnesium stent insertion is feasible for BES without causing severe injury or tissue reaction.Our study suggests that insertion of silicone-covered magnesium esophageal stent is a promising approach for treating BES.
文摘A 67-year-old man had a sev-ere cough and pulmonary infection for 1 wk before seeking evaluation at our hospital.He had undergone esophagectomy with gastric pull-up and radiotherapy for esophageal cancer 3 years previously.After admission to our hospital,gastroscopy and bronchoscopy revealed a fistulous communication between the posterior tracheal wallnear the carina and the upper residual stomach.We measured the diameter of the trachea and bronchus and determined the site and size of the fistula using multislice computed tomography and gastroscopy.A covered self-expanding Y-shaped metallic stent was implanted into the trachea and bronchus.Subsequently,the fistula was closed completely.The patient tolerated the stent well and had good palliation of his symptoms.
文摘目的：初步探讨 Y 型硅酮气道支架置入治疗气管下段、气管隆突、双主支气和气管食管瘘等复合病变的可行性和疗效。方法根据气道复合病变的特殊解剖结构，设计并裁剪气道 Y 型硅酮支架，在全麻硬质支气管镜引导下，对7例气道复合病变患者置入 Y 型硅酮支架7枚。结果 Y 型硅酮支架均一次性置入成功，7例患者置入内支架后症状均缓解，呼吸困难分级由Ⅲ～Ⅳ级改善为0～Ⅱ级，脉搏血氧饱和度（SpO2）高流量吸氧时的77.0%～90.0%[平均为（84.1±4.5）%]提高至自然呼吸时的90.0%～99.0%[平均为（94.1±2.9）%]，与术前比较差异有统计学意义（P =0.000），主要并发症为咳嗽、异物感、胸痛、肉芽形成和痰液潴留。结论气道 Y 型硅酮支架置入能有效解除气道复合病变，技术可行，操作相对简单、安全，近期疗效可靠，值得进一步推广应用。
