RESUMEN
In a retrospective analysis, we evaluated our results with endoscopic dilation of enterostomy stenoses that complicated gastric procedures performed for the treatment of morbid obesity. Of 541 patients who underwent a gastric procedure for treatment of morbid obesity, we found 19 patients in whom endoscopic dilations of stenoses had been attempted. We also include three patients who had surgery elsewhere but who underwent dilations at our institution. Fourteen had stenoses complicating gastric bypass with Roux-en-Y anastomoses, and eight had stenoses complicating a gastroplasty (gastrogastrostomy). Two different types of dilation were attempted during the interval reviewed--Fogarty balloon dilations and Grüntzig balloon dilations. None of the eight patients with gastroplasties benefited from the attempted dilation, but 10 of the 14 patients with stenoses complicating gastric bypasses have done well. We found no significant difference between Fogarty and Grüntzig balloon dilations. We conclude that balloon dilation is an effective means of treating stenosis that complicates gastric bypass performed with Roux-en-Y anastomoses in cases of morbid obesity.
Asunto(s)
Complicaciones Posoperatorias/cirugía , Gastropatías/cirugía , Estómago/cirugía , Adulto , Constricción Patológica/cirugía , Dilatación , Endoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/terapiaAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Catéteres de Permanencia , Duodeno/lesiones , Arteria Hepática , Infusiones Intraarteriales/instrumentación , Perforación Intestinal/terapia , Neoplasias Hepáticas/secundario , Neoplasias del Colon Sigmoide/tratamiento farmacológico , Anciano , Úlcera Duodenal/terapia , Duodenoscopía , Humanos , MasculinoRESUMEN
A simple and inexpensive external suction-irrigation device, which attaches to the biopsy port of endoscopes, is used to rapidly infuse and aspirate large volumes of fluid. By bypassing the umbilical cord, this system avoids blockage of the instrument while permitting intermittent injections of water and aspirations of luminal contents. It may be operated with one hand. Use of the device as described saves considerable time during many examinations and avoids postponement of other examinations.