Use of covered self-expandable stents for benign colorectal disorders in children
| Autor: | Georg Kähler, Rainer Kubiak, Lucas Wessel, Moritz G. Sold, Bettina Lange |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Enterocutaneous fistula
Male medicine.medical_specialty Colon medicine.medical_treatment Perforation (oil well) Self Expandable Metallic Stents Anastomosis Prosthesis Design 03 medical and health sciences Colonic Diseases 0302 clinical medicine Coated Materials Biocompatible Self-expandable metallic stent Intestinal Stricture medicine Humans Child Hirschsprung's disease Digestive System Surgical Procedures Retrospective Studies medicine.diagnostic_test business.industry Rectum Stent Infant General Medicine equipment and supplies medicine.disease Endoscopy Surgery Rectal Diseases Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health 030211 gastroenterology & hepatology Female business |
| Zdroj: | Journal of pediatric surgery. 52(1) |
| ISSN: | 1531-5037 |
| Popis: | Purpose There is a lack of experience with covered self-expandable stents for benign colorectal disorders in children. Methods Five children (4M, 1F) with a median age of 5years (range, 6months–9years) who underwent treatment with covered self-expandable plastic (SEPSs) or self-expandable metal stents (SEMSs) for a benign colorectal condition between April 2005 and November 2013 were recruited to this retrospective study. Etiologies included: anastomotic stricture with (n=1) or without (n=3) simultaneous enterocutaneous fistula, as well as an anastomotic leak associated with enterocutaneous fistula (n=1). All children suffered from either Hirschsprung's disease (n=3) or total colonic aganglionosis (Zuelzer–Wilson syndrome) (n=2). Results Median duration of individual stent placement was 23days (range, 1–87days). In all cases up to five different stents were placed over time. At follow-up two patients were successfully treated without further intervention. In another patient the anastomotic stricture resolved fully, but a coexisting enterocutaneous fistula persisted. Overall, three patients did not improve completely following stenting and required definite surgery. Stent-related problems were noted in all cases. There was one perforation of the colon at stent insertion. Further complications consisted of stent dislocation (n=4), obstruction (n=1), formation of granulation tissue (n=1), ulceration (n=1) and discomfort (n=3). Conclusions Covered self-expandable stents enrich the armamentarium of interventions for benign colorectal disorders in children including anastomotic strictures and intestinal leaks. A stent can be applied either as an emergency procedure (bridge to surgery) or as an adjuvant treatment further to endoscopy and dilatation. Postinterventional problems are frequent but there is a potential for temporary or definite improvement following stent insertion. |
| Databáze: | OpenAIRE |
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