酸暴露时间比DeMeester评分更好地预测了抗逆流体手术后的结果
Julia R Amundson1,2, Haris Zukancic3, Kristine Kuchta3
1Department of Surgery, NorthShore University Health System, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA. Jamundson2@gmail.com.
Surgical endoscopy
|June 13, 2023
概括
胃食道逆流病 (GERD) 诊断的新指导方针可能会排除一些患者从抗逆流手术 (ARS) 中. 结果在一年内是相似的,但那些被排除在外的人后来出现了更糟糕的症状.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 诊断的标准 诊断的标准
背景情况:
- 胃食道逆流性疾病 (GERD) 诊断标准各不相同,而AGA 2022指南强调酸暴露时间 (AET) 与DeMeester得分相比.
- 这项研究评估了基于不同GERD诊断标准的抗逆流体手术 (ARS) 的结果.
研究的目的:
- 用历史的机构标准与美国胃肠病学协会 (AGA) 的新指南对比诊断为GERD的患者的ARS后的结果.
- 评估诊断标准对患者报告的和客观的外科手术结果的影响.
主要方法:
- 对2010-2022年期间对ARS进行评估的253名患者的前性数据库的回顾性审查.
- 患者接受了手术前的BRAVO (行走式pH测试) ≥48小时.
- 组对比使用威尔科克森等级和费舍尔精确试验,统计学显著性设置为p < 0.05.
主要成果:
- 大多数患者 (86.9%) 符合历史标准,而较少的患者 (67.2%) 符合新的AGA标准.
- 一个仅符合历史标准的小组具有较不严重的GERD表型 (较低的BMI,ASA,椎间,DeMeester和AET).
- 在ARS后1年内,没有观察到术后结果,症状缓解或客观GERD结果的显著差异. 符合历史标准的患者仅在2年后报告了更差的GERD-HRQL和RSI得分.
结论:
- 更新的GAGA GERD指南不包括在历史上被诊断患有GERD的患者,这些患者表现出不那么严重的表型,但具有相当的短期结果.
- 虽然客观结果相似,但长期患者报告的症状表明可能存在超过一年的潜在差异.
- 酸暴露时间 (AET) 可能是一个比DeMeester得分更精确的指标来选择ARS患者.
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