Complex polypectomy in the sigmoid colon using a double-balloon endolumenal intervention platform
Complex polypectomy in the sigmoid colon using a double-balloon endolumenal intervention platform
复制标题
使用双气囊腔内介入平台进行乙状结肠复杂息肉切除术
DOI：
10.1007/s10151-020-02400-9
复制
发表时间：
2021
影响因子：
3.3
通讯作者：
Milsom J. W.
中科院分区：
文献类型：
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作者：
Huang A.;Hirashita T.;Urakawa S.;Hirashita Y.;Alzghari T.;Milsom J. W.
结肠息肉的变化为每位患者带来了独特的挑战。许多因素，如大小，形态和位置可以决定息肉是否可以使用内窥镜技术切除[1]。以前的研究者已经开发了评分系统，以识别切除失败、复发或不良事件风险增加的患者[2]。此外，内镜技术本身在保持位置和手术过程中的反常运动方面存在固有的困难，对于内镜切除技术难度太大的息肉，经腹入路的侵入性治疗可能是唯一可行的选择。然而，这些方法伴随着高昂的医疗费用，漫长的住院时间和并发症的重大风险。一种允许在内窥镜下进行息肉切除术的技术，即使在次优位置、定位或尺寸下也将是有价值的，因为它将减少对侵入性手术的需要。因此，我们介绍了两例患者，其中使用双球囊腔内介入平台（DEIP）允许内镜息肉切除术，而不是侵入性手术。该DEIP（DiLumenTM，Lumendi，韦斯特波特，CT，USA）可商购获得，由柔性聚氨酯外鞘和两个可独立充气的球囊组成。可以在这两个球囊之间形成治疗区，球囊完全膨胀以将器械锚在结肠中[3]。该治疗区提供增加的稳定性和改善的可视化。在
Variations in colonic polyps create unique challenges for every individual patient. Many factors, such as size, morphology, and location can determine whether a polyp can be resected using an endoscopic technique [1]. Previous investigators have developed scoring systems to identify patients in whom there is an increased risk of failed resection, recurrence, or adverse events [2]. Additionally, endoscopic techniques themselves have intrinsic difficulties in maintaining position and with paradoxical movements during the procedure.For polyps that prove too technically difficult for endoscopic resection, invasive treatment via an abdominal approach may be the only viable option. However, these approaches are accompanied by high medical costs, lengthy hospitalization, and significant risk of complications. A technique that allows for polypectomies to be conducted endoscopically even with suboptimal locations, positioning, or size would be valuable since it would reduce the need for invasive surgery. Therefore, we present two patients in whom the use of a double-balloon endolumenal intervention platform (DEIP) permitted an endoscopic polypectomy rather than invasive surgery. This DEIP (DiLumenTM, Lumendi, Westport, CT, USA) is commercially available and comprises of a flexible polyurethane oversheath with two independently inflatable balloons. A therapeutic zone can be made between these two balloons, which are fully inflated to anchor the device in the colon [3]. This therapeutic zone provides increased stability and improved visualization. In
DOI：
10.1007/s00464-018-6336-4
发表时间：
2019-01
期刊：
Surgical endoscopy
影响因子：
--
作者：
Sharma S;Momose K;Hara H;East J;Sumiyama K;Nakajima K;Silbehumer G;Milsom J
通讯作者：
Milsom J