部分覆盖与未覆盖的pyloro-duodenal支架用于不可切除的恶性胃出口阻塞:随机对照研究
Anthony Yuen Bun Teoh1, Sundeep Lakhtakia2, Damien Meng Yew Tan3
1Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
部分覆盖的十二指肠支架 (PCDS) 与未覆盖的十二指肠支架 (UCDS) 相比,在恶性胃出口阻塞中显示出减少瘤内生长的趋势. 然而,这两种类型的支架都没有改善再干预率或支架通透性.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 干预性放射学 干预性放射学
背景情况:
- 恶性胃出口阻塞 (GOO) 显著影响患者的生活质量.
- 十二指管支架的安置是一种常见的息治疗恶性GOO.
- 对比部分覆盖的十二指腺支架 (PCDS) 和未覆盖的十二指腺支架 (UCDS) 对于优化患者的治疗结果至关重要.
研究的目的:
- 为了比较PCDS与UCDS在无法切除的原发性恶性GOO患者中的疗效.
- 作为主要结果,评估再干预率.
- 评估二次结果,包括成功率,不良事件和支架通透性.
主要方法:
- 一项前性国际随机受控研究,涉及115名患有恶性GOO的患者.
- 随机分配患者接受PCDS (n=59) 或UCDS (n=56).
- 主要终点是1年重复干预率;次要终点包括技术/临床成功,不良事件和支架通透性.
主要成果:
- 在PCDS和UCDS之间1年的再干预率没有显著差异 (20.3%对25%,P=0.84).
- 在PCDS中观察到较低瘤内生长的趋势 (10.2%对23.2%,P=0.07).
- 技术成功,临床成功,手术时间,住院,30天不良事件和30天死亡率在各组之间相似.
结论:
- 使用PCDS与瘤生长风险降低有关,但并没有显著改善再干预率或支架通透性.
- 两种PCDS和UCDS都是管理恶性GOO的可行的选择.
- 进一步的研究可能会根据特定的患者和瘤特征来探索最佳的支架选择.
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