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与阿喀拉西亚口腔内镜肌瘤早期失败相关的因素
Blandine Vauquelin1, Lucille Quénéhervé2, Mathieu Pioche3
1Gastroenterology and Hepatology Department, INSERM CIC 1401, Haut-Lévêque University Hospital, Bordeaux, France.
Gastrointestinal endoscopy
|October 8, 2023
概括
门内镜肌切除术 (POEM) 对于阿喀拉西亚是有效的,但早期失败 (<10%) 与年轻年龄,阿喀拉西亚类型I/III和高的术前埃卡德得分有关. 识别这些因素可以改善患者的治疗结果.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 外科手术的结果
背景情况:
- 口腔内镜肌切除术 (POEM) 是治疗阿哈拉西亚的主要治疗方法.
- 预测早期POEM失败的因素需要进一步阐明,特别是在欧洲患者群体中.
研究的目的:
- 为了确定初级头痛症的口腔内镜肌切除术 (POEM) 后早期治疗失败的预测因素.
主要方法:
- 一项多中心回顾性研究包括746名成人患者,他们首次接受了阿喀拉西亚的POEM治疗.
- 早期失败被定义为在手术后3个月的埃卡德得分>3.
- 分析了两个队列:总人口队列和病例对照队列 (早期失败与成功的比率为 1:2).
主要成果:
- 整体早期故障率为9.4%.
- 早期失败的预测因素包括年轻年龄 (≤45岁),类型I和III的阿喀拉西亚,以及POEM期间的严重不良事件.
- 在病例对照分析中,高的POEM前Eckardt评分是一个额外的独立风险因素,而背骨疼痛是显著的子评分.
结论:
- 在阿卡拉西亚中,POEM的早期失败率低于10%.
- 较年轻的患者,患有I/III型阿喀拉西亚的患者,以及高于POEM前Eckardt分数的个人,患早期治疗失败的风险增加.
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