laparoscopic 抗逆流症手术与慢性 GERD 的埃索梅普拉治疗:LOTUS 随机临床试验
Jean-Paul Galmiche1, Jan Hatlebakk, Stephen Attwood
1Department of Gastroenterology and Hepatology, Nantes University, CIC INSERM, Place Alexis Ricordeau, 44093 Nantes, France. jeanpaul.galmiche@chu-nantes.fr
优化埃索美普拉治疗和腹腔镜抗逆流症手术 (LARS) 都有效地长期管理胃食道逆流症 (GERD). 大多数患者在两种治疗中都在5年内实现了缓解,结果相似.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 药理疗法 药理疗法 药理疗法
背景情况:
- 胃食道逆流性疾病 (GERD) 是一种影响日常生活的慢性疾病.
- 目前的治疗方法包括长期的药物治疗或手术.
研究的目的:
- 为了比较优化埃索梅普拉治疗与腹腔镜抗逆流手术 (LARS) 对于GERD管理.
- 评估长期疗效和患者的结果.
主要方法:
- 莲花试验是一项在11个欧洲国家进行的为期5年的随机化开放性研究.
- 最初包括554名患有慢性GERD的患者;372人完成了随访.
- 患者接受了埃索梅普拉 (20-40毫克/天) 或LARS.
主要成果:
- 估计的5年缓解率为埃索梅普拉的92%和LARS的85% (P=.048).
- 症状形状有所不同,在埃索梅普拉组中,胃烧/吐较少,在LARS组中,消化不良/膨胀/浮较少.
- 在两组中,严重不良事件和死亡率相似且低.
结论:
- 优化的埃索梅普拉和LARS都在5年内为GERD患者提供持续缓解.
- 当代抗逆流疗法提供了有效的长期管理选择.
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