Fluoroscopy-guided placement of transanal decompression tube as a bridge measure in laparoscopic surgery of sigmoid volvulus
10.3969/j.issn.1008-794X.2024.11.010
- VernacularTitle:X线透视下经肛肠梗阻导管置入桥接腹腔镜手术治疗乙状结肠扭转
- Author:
Yongtuan GUO
1
;
Dechun LI
;
Guangming WANG
;
Bin QUAN
;
Hongtao DU
Author Information
1. 221009 江苏徐州徐州市中心医院放射科
- Keywords:
sigmoid volvulus;
interventional radiology;
laparoscope
- From:
Journal of Interventional Radiology
2024;33(11):1208-1211
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of fluoroscopy-guided placement of transanal decompression tube as a bridge measure in laparoscopic surgery of sigmoid volvulus.Methods The data of 21 patients with sigmoid volvulus without intestinal necrosis,who were admitted to the Xuzhou Municipal Central Hospital of China from January 2014 to October 2023,were retrospectively analyzed.The patients received fluoroscopy-guided placement of transanal decompression tube first.After the clinical symptoms disappeared,laparoscopic sigmoid resection was carried out.The success rate of interventional operation,time spent for interventional procedure,postoperative 24-hour remission rate of clinical symptoms,incidence of interventional complications,frequency of transferring to emergency surgery,time from tube placement to laparoscopic surgery,intraoperative intestinal conditions,incidence of postoperative anastomotic fistula and anastomotic infection,and perioperative mortality were calculated.Results The success rate of interventional operation in 21 patients was 100％,the mean time spent for interventional procedure was(9.9±2.5)min,and the postoperative 24-hour remission rate of clinical symptoms was 100％.No interventional complications such as intestinal perforation or intestinal bleeding occurred in all the 21 patients.None of the patients was transferred to emergency surgery.The mean time from tube placement to laparoscopic surgery was(9.0±2.8)days.During the operation,the restoration of sigmoid volvulus was accomplished in all patients.No obvious congestion or oedema of the intestinal wall was observed.Postoperative anastomotic infection occurred in one patient,which was cured after symptomatic treatment,and no anastomotic fistula occurred in all patients.No perioperative death occurred.Conclusion For the treatment of sigmoid volvulus,fluoroscopy-guided placement of transanal decompression tube is technically-simple,clinically safe and effective,and the emergency surgery can be replaced by selective laparoscopic sigmoid resection surgery with one-stage intestinal anastomosis.The incidences of postoperative complications and perioperative mortality are very low.
