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磁性关节增大用于胃食道逆流病的安全性概况
Caterina Froiio1, Alberto Aiolfi2, Davide Bona2
1Department of Biomedical Science for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.
Frontiers in surgery
|November 29, 2023
概括
由于改进的技术,磁性缩器增大 (MSA) 移除率在2014年后显著下降. 调整器件尺寸和手术方法可以提高胃食道逆流症 (GERD) 治疗的结果.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 医疗器械技术 医疗器械技术
背景情况:
- 磁性缩器增大 (MSA) 是胃食道逆流症 (GERD) 的有效治疗方法.
- 需要移除MSA设备的不良事件被认为是罕见的,但其实际患病率可能被低估.
- 了解影响MSA解释的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了确定MSA扩散的流行率和发病率.
- 分析MSA设备移除的趋势,包括手术技术和患者结果的变化.
- 确定与MSA探索相关的因素,并探索减少去除率的策略.
主要方法:
- 对2007年3月至2021年9月期间接受MSA治疗的患者前性收集数据库的回顾性分析.
- 包括来自两个专门从事食道手术的三级护理转诊中心的患者.
- 审查MSA的扩张趋势,大小测量技术,crura修复方法,扩张程序和修复手术结果.
主要成果:
- 在397名患者中,有50名 (12.4%) 需要进行MSA切除,中位时间为39.5个月.
- 消化不良 (43.2%),胃灼热 (25%) 和腹上疼痛 (13.6%) 是去除的主要原因.
- 2014年以后的大小和crura修复的变化显著减少了从23%到5%的爆发发病率 (p < 0.0001).
- 多变量分析证实,设备中增加的珠子单位提供了防止移除的保护作用 (HR 0.06; p < 0.000).
结论:
- 手术技术的修改,包括大小和形修复,已经明显减少了对MSA检查的需求.
- 过大尺寸的设备和采用特定的外科手术方法,如完全的中椎切割与后部膜整形,可以进一步改善MSA手术的结果,并降低切除率.
- 持续改进手术技术对于优化磁性关节增大在GERD管理中的长期成功至关重要.
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