RESUMO
OBJECTIVE: To evaluate the possibility and safety of modified endoscopic stent in the treatment of benign intestinal fistulas. MATERIAL AND METHODS: Analysis of the experience of Sklifosovsky Research Institute for Emergency Care and recent numerous foreign reports confirms that staged treatment followed by delayed radical surgery is the most perspective approach. Modified endoscopic treatment of intestinal fistulas successfully used in 10 patients is reported in the article. RESULTS: Endoscopic stenting of various parts of gastrointestinal tract is a minimally invasive treatment of this pathology and not followed by complications and mortality. An important advantage is early closure of fistula that reduces duration of treatment and improves further social and labor rehabilitation of patients.
Assuntos
Fístula Intestinal/cirurgia , Endoscopia , Humanos , Fístula Intestinal/etiologia , Implantação de Prótese , Stents , Resultado do TratamentoRESUMO
AIM: To develop medical algorithms for reduction of morbidity and mortality in rare forms of mechanical intestinal obstruction. MATERIAL AND METHODS: 17 patients with mechanical intestinal obstruction have been operated in Sklifosovsky Research Institute for Emergency Care for the period 2010 - 2016. There were 13 women and 4 men aged 56 (44,5-74,5) years on the average. Phytobezoar was detected in 7 patients (41.2%), tumor in 7 patients (41.2%) and gallstone ileus in 3 patients (17.6%). RESULTS: There were no complications in group 1. In group 2 postoperative complications occurred in 3 patients: gastrocnemius vein thrombosis followed by successful medication (Clavien-Dindo type II), abdominal abscess drained under ultrasonic control (Clavien-Dindo type IIIa) and 1 (8.3%) death (Clavien-Dindo type V). Postoperative mortality in group 2 was 8.3%. CONCLUSION: Despite small sample size and no statistically reliable results the advantages of minimally invasive access are obvious. However, further trials are required to ensure the reliability of the results.
