术前食道检测可以预测手套胃切除术患者的术后逆流状况
Rachel Sillcox1, Saurabh Khandelwal2, Mary Kate Bryant2
1Department of Surgery, University of Washington, Seattle, WA, USA. rachel.sillcox@gmail.com.
Surgical endoscopy
|June 1, 2023
概括
手术前的GERD负担,而不是运动性,预测垂直袖胃切除术 (VSG) 后的反流. 超过24.8的异常DeMeester得分表明术后GERD的风险较高,指导患者咨询.
科学领域:
- 胃肠病学 胃肠病学
- 腹部外科 腹部外科
- 食道生理学 食道生理学
背景情况:
- 垂直袖子胃切除术 (VSG) 可以导致术后胃食道逆流病 (GERD).
- 吸收性GERD是将VSG转换为Roux-en-Y胃绕道的常见原因.
- 术前的pH和测量力测试用于在VSG之前评估GERD风险.
研究的目的:
- 调查手术前食道功能测试在VSG后术后GERD的预测价值.
- 确定异常的pH值研究和无效的食道运动性是否预测VSG后的逆流症状.
- 确定用于预测术后逆流的特定pH值和压力学值.
主要方法:
- 对291名接受VSG的成年患者进行了回顾性审查,并进行了手术前的pH值和测力测量 (2015-2021).
- 在1年的随访中评估手术前的反流症状和手术后的反流.
- 统变逻辑回归和Lui方法用于分析pH值和测量力数据.
主要成果:
- 22.7%的人有运动障碍,23%的人有异常的DeMeester分数. 41.9%的人报告了手术前的反流.
- 在手术前的pH/心力测量异常和BMI降低并不能预测手术后的逆流.
- 在pH值异常的患者中,DeMeester评分>24.8预测了显著更高的术后逆流率 (41.9%与17.1%,p=0.03).
结论:
- 食道测量异常没有预测术后逆流.
- 根据DeMeester分数显示的手术前GERD负担的严重程度是术后逆流的重要预测指标.
- 手术前的pH测试,特别是DeMeester评分,可以帮助手术决策和患者咨询VSG风险.
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