结肠镜穿孔意外的最新治疗方法

一项新的技术可以在伤口确定的同时闭合意外结肠镜所致的损伤，由此避免了侵入性的手术。

美国德州医疗分支机构研发了一项能闭合穿孔的技术，通过内镜进入肛门将环针和缝线运送到伤口处 。相似的方法已应用于腹腔镜治疗使损伤最小。

在做肠镜的过程中，外科医生可能意外导致两种主要的穿孔：一种是由结肠延伸过长造成的，另一种是由去除息肉时造成的。把猪作为实验模型，学者们利用内镜将小金属环针送入体内，成功闭合小于1英尺的结肠穿孔。这项新技术于2007年五月在美国胃肠内镜年会上作了展示。

第一作者G.S. Raju博士说：“我们通过一系列的试验表明能通过内镜成功修复两种类型的穿孔。而不需进行侵入性的手术。” 

每1000到2000例结肠内镜检查中就有1例可因医生的过失造成结肠穿孔。这类病人的大多数需要进行紧急手术闭合伤口并且需要在医院内治疗10天。10例病人中会有1例死亡，通常是由于闭合穿孔不及时使 结肠内容物漏入腹腔，导致致死性的腹膜炎和脓毒败血症。 

A new technique closes accidental colonoscopy wounds soon after they are identified,  thus avoiding invasive surgery. 

Following a series of animal studies, researchers at the University of Texas Medical Branch (UTMB; Galveston, USA) developed a technique for closing perforations promptly after they 
are recognized by using clips or sutures that can be inserted through the anus viaendoscope. Similar clips and sutures have been used for some time by surgeons performing 
minimally invasive laparoscopic procedures, including several gynecologic operations and  other procedures such as gall bladder removal. 

During colonoscopies, surgeons may accidentally cause two principal types of perforations; one results from overstretching the colon, the other from removal of polyps. Working withpigs as an experimental model, the researchers successfully closed colon perforations of less than one inch with small metal clips inserted via endoscopes. The new technique was  presented at the annual meeting of the American Society of Gastrointestinal Endoscopy, held  during May 2007 in Washington DC (USA). e have shown in a series of experiments that both types of perforations can be closed  successfully using an endoscope without the need for invasive surgery,?said lead author,  UTMB associate professor of gastroenterology G.S. Raju, M.D. 揥e have even accomplished a  leak-proof seal of the perforation.?

In one out of every 1,000 to 2,000 colonoscopies, doctors inadvertently perforate the colon.  Most of these patients need urgent surgery to close the wound and spend 10 days in the  hospital. One in 10 dies, usually because delays in closing perforations allow colon  contents to leak into the abdominal cavity, causing deadly conditions such as peritonitis  and sepsis.