紧缩克罗恩病:内镜支架的作用是什么? 一个系统的审查
Giorgia Burrelli Scotti1, Roberto Lorenzetti2, Annalisa Aratari3
1Department of Surgery, Sapienza University of Rome, Rome, Italy.
Clinical endoscopy
|November 2, 2023
概括
内镜支架为克罗恩氏病狭窄症提供了可行的二线治疗方法,可能会延迟手术. 计划采用部分覆盖的自扩张金属支架 (PCSEMS) 显示了对这些狭窄的有希望的长期疗效.
科学领域:
- 胃肠病学 胃肠病学
- 内镜治疗药物 内镜治疗药物
- 炎症性肠道疾病 炎症性肠病
背景情况:
- 克罗恩病 (CD) 狭窄症是一个重大的临床挑战.
- 内镜支架是一种新兴的CD狭窄治疗方法,与内镜气球扩张 (EBD) 相比,它显示了持续扩张的潜力.
研究的目的:
- 评估内镜支架在克罗恩病治疗狭窄的疗效和安全性.
- 分析与部分覆盖的自扩张金属支架 (PCSEMS) 相关的结果.
主要方法:
- 进行了一次系统的文献搜索 (PROSPERO; no. CRD42022308033) 的情况.
- 主要结局包括技术成功,疗效,并发症率和需要进一步干预的再阻塞.
- 专门分析了七天检索PCSEMS的结果.
主要成果:
- 审查了11项涉及173名CD狭窄患者的研究.
- 平均技术成功率为95%;短期疗效率为100%,长期疗效率为56%.
- 对于计划PCSEMS检索,长期疗效为76%,平均并发症率为35%,主要并发症率为11%.
结论:
- 内镜支架,特别是有计划的PCSEMS检索,是短期CD狭窄的可行的二线选择,可能推迟手术.
- 需要进一步进行大规模的头对头前性研究,以确定支架作为CD管理中的EBD替代品或辅助器的作用.
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