Magnetic surgery clinic

  • 文章类型: Case Reports
    背景:直肠癌切除术后吻合口狭窄的治疗具有挑战性。内镜下球囊扩张和放射状切口对所有患者均无效。我们提出了一种新的内窥镜辅助磁压缩技术(MCT),用于治疗直肠吻合口狭窄。我们成功地将此MCT应用于直肠癌根治术后发生吻合口狭窄的患者。
    方法:5个月前,一名50岁男子在当地医院接受了腹腔镜直肠癌根治术。2个月前进行的结肠镜检查表明,直肠吻合狭窄,因此无法进行回肠造口术闭合。得知我们已成功使用MCT治疗结直肠狭窄患者后,患者来到西安交通大学第一附属医院磁疗门诊。我们进行了内窥镜辅助的直肠狭窄磁加压手术。磁体在16d后被移除。4个月后进行的随访结肠镜检查显示吻合口通畅,之后,进行回肠造口术闭合手术。
    结论:MCT是一个简单的,非侵入性技术治疗直肠癌根治术后吻合口狭窄。该技术可广泛用于临床设置。
    BACKGROUND: The treatment of postoperative anastomotic stenosis after excision of rectal cancer is challenging. Endoscopic balloon dilation and radial incision are not effective in all patients. We present a new endoscopy-assisted magnetic compression technique (MCT) for the treatment of rectal anastomotic stenosis. We successfully applied this MCT to a patient who developed an anastomotic stricture after radical resection of rectal cancer.
    METHODS: A 50-year-old man had undergone laparoscopic radical rectal cancer surgery at a local hospital 5 months ago. A colonoscopy performed 2 months ago indicated that the rectal anastomosis was narrow due to which ileostomy closure could not be performed. The patient came to the Magnetic Surgery Clinic of the First Affiliated Hospital of Xi\'an Jiaotong University after learning that we had successfully treated patients with colorectal stenosis using MCT. We performed endoscopy-assisted magnetic compression surgery for rectal stenosis. The magnets were removed 16 d later. A follow-up colonoscopy performed after 4 months showed good anastomotic patency, following which, ileostomy closure surgery was performed.
    CONCLUSIONS: MCT is a simple, non-invasive technique for the treatment of anastomotic stricture after radical resection of rectal cancer. The technique can be widely used in clinical settings.
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  • 文章类型: Case Reports
    背景:磁性压缩吻合术(MCA)和内窥镜检查的组合已用于治疗肝移植后的胆管狭窄。然而,其用于严重腹部创伤后复杂胆道梗阻的治疗尚未见报道。此病例报告描述了MCA成功用于治疗因重大腹部创伤引起的胆道梗阻。
    方法:一名23岁男子接受了腹部大手术(肝破裂修复,右半结肠切除术,和回肠造口术)一年前发生车祸后。腹部引流管,位于温斯洛孔处,每天排出约600-800毫升胆汁。在两次内镜逆行胰胆管造影术中,导丝无法进入胆总管,这阻止了胆道支架的放置。MCA联合内镜成功实现腹膜窦道与十二指肠的磁吻合,然后放置胆总管十二指肠支架。最后,拔除外部胆道引流管。患者实现了胆道内引流,从而拔除了胆道外引流管,提高了生活质量。
    结论:磁压迫技术可用于复杂胆道梗阻的治疗,手术创伤小。
    BACKGROUND: The combination of magnetic compression anastomosis (MCA) and endoscopy has been used to treat biliary stricture after liver transplantation. However, its use for the treatment of complex biliary obstruction after major abdominal trauma has not been reported. This case report describes the successful use of MCA for the treatment of biliary obstruction resulting from major abdominal trauma.
    METHODS: A 23-year-old man underwent major abdominal surgery (repair of liver rupture, right half colon resection, and ileostomy) following a car accident one year ago. The abdominal drainage tube, positioned at the Winslow foramen, was draining approximately 600-800 mL of bile per day. During the two endoscopic retrograde cholangiopancreatography procedures, the guide wire was unable to enter the common bile duct, which prevented placement of a biliary stent. MCA combined with endoscopy was used to successfully achieve magnetic anastomosis of the peritoneal sinus tract and duodenum, and then a choledochoduodenal stent was placed. Finally, the external biliary drainage tube was removed. The patient achieved internal biliary drainage leading to the removal of the external biliary drainage tube, which improved the quality of life.
    CONCLUSIONS: Magnetic compression technique can be used for the treatment of complex biliary obstruction with minimal operative trauma.
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  • 文章类型: Case Reports
    背景:结直肠癌切除术后吻合口狭窄(AS)的治疗具有挑战性。在这种情况下,内窥镜球囊扩张术用于治疗狭窄,但是有些患者即使在多次球囊扩张后也没有表现出改善。磁压缩技术(MCT)已用于胃肠道吻合,但其用于治疗结直肠癌术后AS的手术方法鲜有报道。
    方法:我们报道了一名72岁的男子,他在一年前接受了结直肠癌的根治性切除和回肠造口术。六个月前准备了回肠造口术,但结肠镜检查显示直肠吻合口狭窄.内镜下球囊扩张术3次,但结肠镜检查显示狭窄无明显改善.使用MCT成功治疗AS。
    结论:MCT是一种微创方法,可用于结直肠癌术后AS的治疗。
    BACKGROUND: The treatment of postoperative anastomotic stenosis (AS) after resection of colorectal cancer is challenging. Endoscopic balloon dilation is used to treat stenosis in such cases, but some patients do not show improvement even after multiple balloon dilations. Magnetic compression technique (MCT) has been used for gastrointestinal anastomosis, but its use for the treatment of postoperative AS after colorectal cancer surgery has rarely been reported.
    METHODS: We report a 72-year-old man who underwent radical resection of colorectal cancer and ileostomy one year ago. An ileostomy closure was prepared six months ago, but colonoscopy revealed a narrowing of the rectal anastomosis. Endoscopic balloon dilation was performed three times, but colonoscopy showed no significant improvement in stenosis. The AS was successfully treated using MCT.
    CONCLUSIONS: MCT is a minimally invasive method that can be used for the treatment of postoperative AS after colorectal cancer surgery.
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  • 文章类型: Review
    背景:结直肠癌术后吻合口狭窄的治疗通常具有挑战性,尤其是对内窥镜检查反应不佳的患者。如果患者接受了肠造口术,狭窄可以很容易地解决通过磁压缩。然而,普通的磁压缩技术不能对那些没有肠造口术的人进行。我们设计了一种新型的Y-Z可变形磁环(Y-ZDMR),并成功地将其应用于直肠癌手术后直肠吻合狭窄且没有肠造口的患者。
    方法:我们在此报告一例57岁女性因直肠癌行腹腔镜直肠癌根治术(Dixon)。然而,手术后6个月,她开始面临排便困难。她的结肠镜检查显示直肠吻合口狭窄。对她进行了六次内窥镜球囊扩张术。然而,狭窄仍有逐渐加重的趋势。因为病人没有接受肠造口术,传统的内窥镜磁压缩技术无法执行。因此,我们在单通道下通过肛门实施了Y-ZDMR。术后9天磁性环脱落,直肠狭窄缓解。患者随访6个月,报告排便良好。
    结论:Y-ZDMR可变形磁环是直肠狭窄且无肠造口患者的一种极好的治疗策略。
    BACKGROUND: Treatment of postoperative anastomotic stenosis for colorectal cancer is often challenging, especially for patients who do not respond well to endoscopy. In cases where patients have undergone an enterostomy, the stenosis can be easily resolved through magnetic compression. However, common magnetic compression techniques cannot be performed on those without enterostomy. We designed a novel Y-Z deformable magnetic ring (Y-Z DMR) and successfully applied it to a patient with a stenosis rectal anastomosis and without enterostomy after rectal cancer surgery.
    METHODS: We here report the case of a 57-year-old woman who had undergone a laparoscopic radical rectum resection (Dixon) for rectal cancer. However, she started facing difficulty in defecation 6 months after surgery. Her colonoscopy indicated stenosis of the rectal anastomosis. Endoscopic balloon dilation was performed six times on her. However, the stenosis still showed a trend of gradual aggravation. Because the patient did not undergo an enterostomy, the conventional endoscopic magnetic compression technique could not be performed. Hence, we implemented a Y-Z DMR implemented through the anus under single channel. The magnetic ring fell off nine days after the operation and the rectal stenosis was relieved. The patient was followed up for six months and reported good defecation.
    CONCLUSIONS: The Y-Z DMR deformable magnetic ring is an excellent treatment strategy for patients with rectal stenosis and without enterostomy.
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