长段巴雷特食道的管理
Sarah E Kim1, Francisco Schlottmann1,2, Mario A Masrur1
1Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.
概括
长段巴雷特食道 (BE) 与短段BE相比,具有更高的扩张不良和食道腺癌的风险. 目前的管理策略不能充分考虑这种差异,这表明需要更积极的方法来长段BE.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 胃肠内镜检查 胃肠内镜检查
背景情况:
- 巴雷特食道 (Barrett's esophagus,BE) 是胃食道逆流症的一种并发症.
- BE管理通常侧重于发育不良,但段长可能会影响风险.
- 长段BE (LSBE) 和短段BE (SSBE) 需要不同的管理考虑.
研究的目的:
- 评估BE段长度对生殖不良和恶性转变风险的影响.
- 确定LSBE与SSBE的最佳管理策略.
- 根据时间长度,为临床指南提供关于BE监测和治疗的信息.
主要方法:
- 对PubMed,Embase和Cochrane数据库进行系统的文献审查.
- 定义LSBE为≥3厘米,SSBE为<3厘米.
- 包括比较SSBE和LSBE的行为和管理的研究.
主要成果:
- 与SSBE相比,LSBE显示出更高的发育不良和食道腺癌的风险.
- 目前的BE管理协议通常不会根据段长进行区分.
- 内镜和除性治疗可能更成功,SSBE的并发症更少.
- 通过减少监测间隔,LSBE管理可能会受益.
结论:
- 有证据表明,由于恶性进展风险增加,LSBE需要更积极的管理.
- 当前的BE管理算法可能需要修改,以纳入段长.
- 根据细分长度量身定制BE治疗和监测对于改善患者的治疗结果至关重要.
相关概念视频
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