单通道内镜下荷包缝合术在右半结肠病变ESD术后创面中的临床应用

发布时间：2018-05-28 00:27

本文选题：内窥镜检查 + 荷包缝合技术　；参考：《南京医科大学学报(自然科学版)》2017年12期

【摘要】：目的 :探讨单通道内镜下荷包缝合技术在右半结肠内镜黏膜下剥离术(endoscopic submucosal disection,ESD)术后创面缝合的效果、安全性及优势。方法:对于右半结肠ESD的患者应用单通道内镜下荷包缝合技术对创面进行缝合,观察其疗效、安全性及优势。结果:共15例右半结肠ESD术后创面,其中6例病变位于回盲部,4例位于升结肠,5例位于横结肠;本组中1例穿孔。全部病例均获得满意缝合效果,ESD术后创面闭合,穿孔封闭,其中穿孔的患者出现发热、腹痛等不适,白细胞升高,经保守治疗后治愈,其余患者无出血等并发症发生。结论:单通道内镜下荷包缝合技术对于右半结肠ESD术后创面的闭合而言操作简洁,不用换双通道内镜进行内镜下缝合,还能有效地防止术后创面的迟发性出血及穿孔,并且可以促进创面的愈合,临床疗效好,安全,较双通道内镜更有优势。
[Abstract]:Objective: to evaluate the efficacy, safety and advantages of single channel endoscopic purse suture in the treatment of endoscopic submucosal dissection. Methods: single channel endoscopy was used to suture the wound in patients with right hemicolon ESD. The curative effect, safety and advantage of the suture were observed. Results: there were 15 cases of right hemicolon wound after ESD, of which 6 cases were located in ileocecal part, 4 cases were located in ascending colon, 5 cases were located in transverse colon, 1 case was perforated. Satisfactory suture effect was obtained in all cases. The wound was closed and perforated after ESD. The patients with perforation had fever, abdominal pain, leukocyte elevation, and were cured after conservative treatment, and no complications such as bleeding occurred in the other patients. Conclusion: the single channel endoscope purse suture technique is simple for the closure of the wounds after right hemicolon ESD, and can effectively prevent the late bleeding and perforation of the wounds after the operation without using the double channel endoscope for endoscopic suture. And can promote wound healing, clinical efficacy, safety, than double-channel endoscopy more advantages.
【作者单位】：南京医科大学第一附属医院消化内镜中心;
【基金】：江苏省卫计委面上项目(H201502 EA15)
【分类号】：R656.9

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