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减轻腹部手术后新发巴雷特食道风险:国家数据库研究
Alexander Hurtado1, Apoorva K Chandar2, Jaime Abraham Perez3
1Case Western Reserve University School of Medicine, Cleveland, Ohio.
概括
腹腔外科手术,包括袖子胃切除术 (SG) 和Roux-en-Y胃绕道 (RYGB),可显著降低患巴雷特食道 (BE) 的风险. 这种保护作用主要与手术后的大量体重和BMI减轻有关.
科学领域:
- 胃肠病学 胃肠病学
- 腹部外科 腹部外科
- 在瘤学瘤学.
背景情况:
- 减肥手术是对肥胖的公认治疗方法.
- 肥胖与某些癌症的风险增加有关.
- 减肥手术对食道疾病 (如巴雷特食道) 的影响需要进一步调查.
研究的目的:
- 在减肥手术后比较巴雷特食道新发症 (BE) 的风险与非手术对照.
- 评估减肥手术 (袖子胃切除术和Roux-en-Y胃绕道术) 与BE诊断之间的关联.
- 评估体重和BMI降低对减肥手术后的BE风险的影响.
主要方法:
- 对大型国家医疗保健数据库 (TriNetX) 的分析.
- 进行袖子胃切除术 (SG) 或Roux-en-Y胃绕道术 (RYGB) 的成年患者与接受查结肠镜检查的对照进行倾向匹配的比较.
- 在手术后至少一年的时间内评估新的BE诊断,并对代谢结果进行二次分析,并对SG和RYGB进行比较.
主要成果:
- 与查结肠镜对照 (OR 0.67,95% CI [0.48,0.94]) 相比,腹腔外科手术与新发巴雷特食道 (BE) 的风险显著降低.
- 患者经历了重量和BMI的显著减轻后腹部外科手术.
- 在袖子胃切除术和Roux-en-Y胃绕道术之间没有观察到新的BE风险的显著差异.
结论:
- 腹腔外科手术 (SG或RYGB) 与非手术对照相比,与巴雷特食道 (BE) 的发病率较低有关.
- 体重和BMI的降低似乎是这种保护作用的关键媒介.
- 在SG和RYGB之间做出选择并没有显著影响发展BE的风险.
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