与内镜切除相关的结直肠狭窄:风险因素,管理和长期结果
Sunil Gupta1,2, Sergei Vosko1, Neal Shahidi1,3
1Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.
Endoscopy
|June 6, 2023
概括
肠直肠光线≥90%的内镜切除缺陷经常导致严重的狭窄,需要早期气球扩张. 缺陷<60%对轻度狭窄的风险很小,突出显示缺陷大小是内镜切除后结直肠狭窄形成的关键因素.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 结肠直肠医学是什么意思
背景情况:
- 结肠直肠狭窄可以复杂化大非支柱型结肠直肠多体 (LNPCPs) 的内镜切除 (ER).
- 关于这些狭窄的患病率,风险因素和管理的数据有限.
- 这项研究解决了对更好的理解和管理策略的需求.
研究的目的:
- 为了前性地评估LNPCPs的ER后结直肠狭窄的患病率和风险因素.
- 描述这些结构的管理方法.
- 为了确定严重狭窄形成的预测因素.
主要方法:
- 未来150个月 (至2021年6月) 的数据收集对LNPCPs≥40mm.进行ER的患者进行前性数据收集.
- 对ER缺陷大小的分类:<60%,60%-89%,和≥90%的光环周长.
- 狭窄分类:严重 (阻塞性症状),中度 (结肠镜不通过),轻度 (抵抗).
主要成果:
- 总共分析了916名患者中的916个LNPCP.
- 狭窄形成的风险:74.2%的缺陷≥90%,25.0%的60%-89%,和0.8%的<60%.
- 严重的狭窄只发生在≥90% (22.6%) 的缺陷中,并且需要比中度狭窄更早,更频繁的气球扩张.
结论:
- 内镜切除缺陷≥90%的光环周长与狭窄形成的高风险有关,通常是严重的.
- 与缺陷<60%相关的狭窄性很少见,通常是轻微的.
- 缺陷大小是ER后结直肠狭窄症严重程度和管理需求的关键决定因素.
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