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Endoscopic Stricturotomy for Enteral Nutrition Access in Patients with Benign Gastrointestinal Strictures:a Review
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作者 YU PING WANG ZE HAO ZHUANG 《Journal of Nutritional Oncology》 2022年第1期3-8,共6页
Benign gastrointestinal stricture significantly restricts enteral nutrition,which directly affects the quality of life of patients.Advances in endoscopic techniques have provided a minimally invasive means of reconstr... Benign gastrointestinal stricture significantly restricts enteral nutrition,which directly affects the quality of life of patients.Advances in endoscopic techniques have provided a minimally invasive means of reconstructing the enteral nutrition pathway in patients with gastrointestinal strictures.Endoscopic stricturotomy is a safe and effective way to open the nutritional pathway,especially for those with anatomic stricture length<1 cm,and can be used either as the primary choice of treatment for patients with gastrointestinal stricture or as rescue therapy for refractory cases.Endoscopic stricturotomy can be executed with radial incision and cutting or circular incision and cutting.After the stricturotomy,other endoscopic treatments,such as endoscopic balloon dilation,stent implantation,and intra-lesional injection of steroids,can be used to prevent the development of re-stricture.This article reviews the clinical experiences with endoscopic stricturotomy for opening strictures along the enteral nutrition pathway in patients with gastrointestinal strictures. 展开更多
关键词 Endoscopic stricturotomy Gastrointestinal stricture Radial incision Circular incision Enteral nutrition pathway
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Interventional inflammatory bowel disease:endoscopic therapy of complications of Crohn’s disease 被引量:2
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作者 Bo Shen 《Gastroenterology Report》 SCIE EI 2022年第1期145-154,共10页
Endoscopic therapy for inflammatory bowel diseases(IBD)or IBD surgery-associated complications or namely interventional IBD has become the main treatment modality for Crohn’s disease,bridging medical and surgical tre... Endoscopic therapy for inflammatory bowel diseases(IBD)or IBD surgery-associated complications or namely interventional IBD has become the main treatment modality for Crohn’s disease,bridging medical and surgical treatments.Currently,the main applications of interventional IBD are(i)strictures;(ii)fistulas and abscesses;(iii)bleeding lesions,bezoars,foreign bodies,and polyps;(iv)post-operative complications such as acute and chronic anastomotic leaks;and(v)colitis-associated neoplasia.The endoscopic treatment modalities include balloon dilation,stricturotomy,strictureplasty,fistulotomy,incision and drainage(of fistula and abscess),sinusotomy,septectomy,banding ligation,clipping,polypectomy,endoscopic mucosal resection,and endoscopic submucosal dissection.The field of interventional IBD is evolving with a better understanding of the underlying disease process,advances in endoscopic technology,and interest and proper training of next-generation IBD interventionalists. 展开更多
关键词 Crohn’s disease COMPLICATION balloon dilation endoscopy FISTULA FISTULOTOMY sinusotomy STRICTURE strictureplasty stricturotomy therapy
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内镜狭窄成形术治疗IBD与非IBD患者的吻合口狭窄 被引量:1
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作者 Long-Juan Zhang Nan Lan +1 位作者 Xian-Rui Wu Bo Shen 《Gastroenterology Report》 SCIE EI 2020年第2期143-150,I0002,I0003,共10页
背景:内镜狭窄成形术(ESt)可有效治疗炎症性肠病(IBD)相关的吻合口狭窄。然而,其用于非IBD患者的吻合口狭窄尚未见报道。本研究旨在评估ESt治疗IBD与非IBD吻合口狭窄的疗效。方法:收集2009-2016年间因吻合口良性狭窄而接受ESt治疗的IBD... 背景:内镜狭窄成形术(ESt)可有效治疗炎症性肠病(IBD)相关的吻合口狭窄。然而,其用于非IBD患者的吻合口狭窄尚未见报道。本研究旨在评估ESt治疗IBD与非IBD吻合口狭窄的疗效。方法:收集2009-2016年间因吻合口良性狭窄而接受ESt治疗的IBD和非IBD病例的临床资料。主要结局指标是无手术生存时间和治疗相关并发症发生率。结果:49例IBD与15例非IBD患者纳入研究。IBD组包括25例克罗恩病患者和24例溃疡性结肠炎储袋患者。非IBD组原发疾病包括结直肠癌7例,憩室病5例,肠脱垂2例,便秘1例。两组所有患者均成功实施ESt治疗。IBD组出现5例次(4.7%,5/106次ESt)的出血并发症,非IBD组则无一例出现并发症(P=0.20)。在内镜随访中,IBD组和非IBD组分别有10例(20.4%)和5例(33.3%)患者狭窄显著改善(P=0.32);最终分别有6例(12.2%)和4例(26.7%)需要手术解除狭窄(P=0.23)。与非IBD患者相比,IBD患者似乎能维持一个更长的无手术生存时间(P=0.08)。结论:内镜狭窄成形术治疗IBD与非IBD吻合口狭窄的疗效相当,尽管非IBD患者或许有更高的需要后续手术治疗的概率,但其并发症发生率似乎较IBD患者更低。 展开更多
关键词 endoscopic stricturotomy inflammatory bowel disease anastomotic stricture
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内镜狭窄切开术对比回结肠切除术治疗克罗恩病原发性末端回肠狭窄
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作者 Nan Lan Tracy L.Hull Bo Shen 《Gastroenterology Report》 SCIE EI 2020年第4期312-318,I0002,共8页
背景:狭窄是克罗恩病的常见表现,绝大多数狭窄出现在末端回肠。本研究旨在比较内镜狭窄切开术(ESt)与回结肠切除术(ICR)治疗克罗恩病原发性末端回肠狭窄的有效性和安全性。方法:从干预性炎症性肠病(i-IBD)中心提取2001-2016年间接受ESt... 背景:狭窄是克罗恩病的常见表现,绝大多数狭窄出现在末端回肠。本研究旨在比较内镜狭窄切开术(ESt)与回结肠切除术(ICR)治疗克罗恩病原发性末端回肠狭窄的有效性和安全性。方法:从干预性炎症性肠病(i-IBD)中心提取2001-2016年间接受ESt和(或)ICR治疗的克罗恩病原发性末端回肠狭窄的连续病例。排除狭窄长度>5 cm或吻合口狭窄者。主要结局指标是无手术生存期和术后并发症。结果:13例行ESt和32例行ICR治疗的患者纳入研究。尽管两组患者狭窄长度相当[(2.46±0.9)cm vs(3.06±1.1)cm,P=0.17],但ICR组患者更多合并梗阻,表现为狭窄前近端肠管扩张(67.7%vs 9.1%,P=0.001)。两组患者治疗后均成功解除梗阻。ESt组和ICR组中位随访时间中位随访时间分别为1.8年和1.5年,再手术率相当(15.4%vs 18.8%,P=0.79),无手术生存率的差异亦无统计学意义(P=0.98)。29次ESt术后出现2例次不良反应,而32次ICR术后则出现了8例次不良反应(6.9%vs 25.0%,P=0.05)。结论:ESt可取得与ICR相当的无狭窄相关手术生存时间,但ESt术后并发症发生率似乎更低。 展开更多
关键词 Crohn’s disease STRICTURE ENDOSCOPY stricturotomy RESECTION
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