腔内金属支架 (LAMS) 彻底改变了以前需要手术的各种胃肠道疾病的治疗方法。使用 LAMS 治疗小肠梗阻 (SBO) 涉及在结肠和梗阻点附近扩张的小肠袢之间进行超声内镜引导结肠肠造口术 (EUS-CE)。该手术对于不适合手术的恶性 SBO 患者可能有益。在两家三级医院进行了一项回顾性队列研究。确定因 SBO 接受 EUS-CE 的患者，并收集有关患者人口统计、手术指征、梗阻位置、手术细节和不良事件的数据。主要成果是手术的技术成功。次要结局包括临床成功、症状缓解、肠内营养耐受能力和不良事件。纳入了 26 名接受 EUS-CE 手术的患者。所有病例 (26/26) 均取得了技术成功，92.3% (24/26) 的患者取得了临床成功（梗阻症状解决），84.6% (22/26) 的患者能够恢复肠内营养。 4 名患者 (15.4%) 发生不良事件，包括出血 (1/26)、腹泻 (2/26) 和术后败血症 (1/26)。患者平均随访时间为 54.8 天（范围 2-190 天）。这项研究强调，EUS-CE 联合 LAMS 可以在治疗 SBO 方面取得高技术和临床成功，特别是对于不适合的恶性梗阻患者手术干预的候选人。更大样本量的进一步研究对于证实其有效性和安全性至关重要。版权所有 © 2023 美国胃肠内窥镜协会。由爱思唯尔公司出版。保留所有权利。

Lumen-apposing metal stents (LAMS) have revolutionized the treatment of various gastroenterological conditions that previously required surgery. The use of LAMS for the management of small-bowel obstruction (SBO) involves endoscopic ultrasound guided colo-enterostomy (EUS-CE) between colon and a dilated loop of the small intestine proximal to the point of obstruction. This procedure is potentially beneficial for patients with malignant SBO who are poor surgical candidates.A retrospective cohort study was conducted at two tertiary care hospitals. Patients who underwent EUS-CE for SBO were identified and data regarding patient demographics, indication for the procedure, location of obstruction, procedural details and adverse events were collected. The primary outcome was technical success of the procedure. Secondary outcomes included clinical success, resolution of symptoms, ability to tolerate enteral nutrition, and adverse events.Twenty-six patients who underwent the EUS-CE procedure were included. Technical success was achieved in all cases (26/26), and clinical success (resolution of obstructive symptoms) was achieved in 92.3% (24/26), and the ability to resume enteral nutrition in 84.6% (22/26) of patients. Adverse events occurred in four patients (15.4%) and included bleeding (1/26), diarrhea (2/26), and post-procedure sepsis (1/26). Patients were followed for a mean of 54.8 days (range 2-190).This study highlights that EUS-CE with LAMS can be performed with high technical and clinical success for the management of SBO, particularly in patients with malignant obstructions who are not suitable candidates for surgical interventions. Further research with larger sample sizes will be essential to substantiate its efficacy and safety.Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.