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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Przegląd techniczny urządzeń do leczenia endoskopowego pacjentów z nieszczelnością górnego odcinka przewodu pokarmowego po zabiegach chirurgicznych

Renato Medas1, Eduardo Rodrigues-Pinto12
Gastroenterologia Kliniczna 2024;16(1):130-149.

Streszczenie

Nieszczelności górnego odcinka przewodu pokarmowego po zabiegach chirurgicznych są trudne do opanowania i często wymagają interwencji radiologicznej, endoskopowej lub chirurgicznej. Endoskopię obecnie uważa się w tych sytuacjach za postępowanie z wyboru, nie uzgodniono jednak jak dotąd najbardziej odpowiedniej strategii terapeutycznej. Opracowano wiele technik endoskopowych, od zabiegów typu close-cover-divert do metod polegających na wytworzeniu aktywnego lub pasywnego drenażu wewnętrznego. Teoretycznie wszystkie te opcje można stosować samodzielnie lub w ramach multimodalnej strategii postępowania, ponieważ każda z nich opiera się na innym mechanizmie działania. Metodę postępowania w przypadku nieszczelności po zabiegu chirurgicznym należy zawsze dostosować do indywidulanej sytuacji każdego pacjenta, uwzględniając różne czynniki, które mogą mieć wpływ na końcowy wynik leczenia. W przedstawionym artykule dokonano przeglądu najważniejszych osiągnięć w zakresie urządzeń endoskopowych do leczenia pacjentów z nieszczelnością po zabiegu chirurgicznym. Skupiono się przede wszystkim na zasadach i mechanizmach działania oraz zaletach i wadach poszczególnych technik i urządzeń, wskazaniach do ich stosowania, skuteczności klinicznej i zdarzeniach niepożądanych. W pracy zaproponowano także algorytm postępowania endoskopowego.

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