手术前的内镜干预预测症状复发或口腔内镜肌肉切除术后的重新干预吗?
Saher-Zahra Khan1,2, Jamie Benson1,2, Christina Boutros1,2
1Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7, Cleveland, OH, 44106, USA.
Surgical endoscopy
|June 16, 2023
概括
在先前进行内镜治疗 (如肉注射或扩张) 后接受口腔内镜肌肉切除术 (POEM) 的患者没有复发的风险增加. 这些发现表明,以前的干预措施不会对阿喀拉西亚患者的POEM结果产生负面影响.
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
- 阿哈拉西亚治疗方法
背景情况:
- 口腔内镜肌切除术 (POEM) 是一种治疗阿喀拉西亚的方法.
- 之前的内镜干预治疗阿喀拉西亚包括注射肉和扩张.
- 之前干预后POEM的结果在复发与初始反应失败方面并没有很好地区分.
研究的目的:
- 调查是否先前的内镜干预 (玻尿酸注射,扩张) 增加了在POEM之后的复发率.
- 为了比较以前未接受过治疗的患者和接受过先前干预的患者的复发率.
主要方法:
- 对164名接受POEM (2011-2022) 的阿喀拉西亚患者进行了回顾性队列研究.
- 患者分为以前未接受过治疗 (TN),注射肉 (BTX),扩张 (BD) 或两组 (BOTH) 的患者.
- 由症状或重新干预的需要定义的复发;用于评估复发几率的后勤回归.
主要成果:
- 两组之间的人口统计或手术前得分没有显著差异.
- 症状复发率和需要手术的比例在不同组中相似.
- 与TN和BD相比,BTX和BOTH组的重复内镜干预率更高.
- 后勤回归显示,以前的干预和复发之间没有统计学上显著的关联.
结论:
- 之前的肉毒素注射或扩张不会增加POEM后复发的可能性.
- 之前进行过内镜干预的患者是POEM的合适候选人.
- 在以前未接受治疗和先前接受治疗的阿喀拉西亚患者之间,POEM的结果是可比的.
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