内镜治疗胃癌术后良性输入袢梗阻的回顾性研究

A retrospective study of endoscopy in treatment of benign afferent loop obstruction after gastrectomy for gastric cancer

摘要:

目的 该研究旨在探讨内镜治疗良性输入袢梗阻的有效性和安全性。方法 选取2000年1月－2018年11月该院远端胃癌切除的患者3 186例，将诊断为良性输入袢梗阻并采用内镜治疗的病例纳入回顾性分析，汇总治疗和随访结果。随访时间为治疗后3、6和12个月。结果 共42例（1.32%）输入袢梗阻病例，包括30例男患者和12例女患者，中位年龄为60岁（36～69岁）。其中39例接受了内镜治疗，治疗后梗阻症状均得到快速缓解，2例患者分别于内镜治疗后4和7个月因粘连导致肠梗阻而行手术治疗。结论 内镜治疗良性输入袢梗阻是安全有效的方法。特别是对于手术风险大的病例，还可以在第一时间对梗阻的输入袢进行减压，为下一步手术做准备，保证手术的安全。

Abstract:

Objective To investigate the effectiveness and safety of endoscopic treatment of benign afferent loop obstruction.Methods A retrospective analysis of the data of 3186 gastric cancer patients who underwent distal gastrectomy from January 2000 to November 2018 was performed. Patients who developed benign afferent loop obstruction were treated by endoscopic treatment. Outcomes were recorded. Follow-up was scheduled at 3, 6 and 12 months after the treatment.Results 42 patients (1.32%) with afferent loop obstruction, consisting of 30 men and 12 women. The median age was 60 years (range 36～69 years). Of these 42 patients, 39 underwent the endoscopic treatment, the obstructive symptoms had a rapid relief after treatment. However, 2 patients underwent surgical treatment because of adhesion at 4 and 7 months after the endoscopic drainage respectively.Conclusion Endoscopic treatment is an effective and safe procedure for benign afferent loop obstruction. In addition, it could provide decompression for the obstructive afferent loop at the first time, preparation for the next operation and guarantee of operation safety, especially in high-surgical-risk patients.