手术前的患者因素和解剖学并不能预测谁会在口腔内镜肌肉切除术后患上逆流
Joshua Lyons1,2, Christina Boutros3,4, Saher-Zahra Khan3,4
1Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7, Cleveland, OH, 44106, USA. Joshua.Lyons@UHHospitals.org.
Surgical endoscopy
|June 21, 2023
概括
胃食道逆流性疾病 (GERD) 是一个关心后,每口腔内镜肌肉切除术 (POEM) 为阿哈拉西亚. 这项研究发现,尽管发生率很高,但没有可靠的术前指标来预测POEM后的GERD发展.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 患者的治疗结果.
背景情况:
- 通过口腔内镜肌切除术 (POEM) 是有效的阿哈拉西亚治疗.
- 与腹腔镜赫勒骨髓切割不同,POEM缺乏常规抗逆流体程序,引发了人们对手术后逆流的担忧.
- 这项研究调查了POEM后胃食道逆流病 (GERD) 的预测因素.
研究的目的:
- 为了确定患者的因素和解剖特征,预测GERD在POEM后的发展.
- 为了评估接受POEM的患者中GERD的发生率.
- 评估术前特征与术后GERD之间的相关性.
主要方法:
- 对179名接受POEM (2014-2022) 的患者进行了回顾性队列研究.
- 术后的门诊pH测试是在停用降酸药6个月后进行的.
- 单变量分析检查了人口统计数据,BMI,阿喀拉西亚类型,下垂,以及作为GERD预测因素的先前治疗 (DeMeester评分>14.7).
主要成果:
- 只有42名患者 (23.5%) 完成了手术后的pH测试;137名 (76.5%) 失去了随访.
- 在那些被测试的人中,23名患者 (55%) 显示出GERD的证据.
- 没有显著的术前患者特征与术后GERD的发展相关.
结论:
- 在接受POEM并完成pH测试的患者中观察到高GERD率 (55%).
- 目前,没有可靠的术前指标可以确定在POEM后患有GERD风险较高的患者.
- 需要进一步的研究来了解和减轻POEM后的GERD风险.
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