对于长段和超长段巴雷特食道的射频剥离的持久性超过10年
Chu Luan Nguyen1,2, David Tovmassian1,2, Michael Zhou2
1Department of Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Concord, NSW, 2139, Australia.
射频切除 (RFA) 在治疗长段 (LSBE) 和超长段巴雷特食道 (ULSBE) 中提供了持续10年的疗效,保持了低并发症率的失生症和肠道转化症的根除. 然而,在ULSBE中,消灭肠道代塑性更具挑战性.
科学领域:
- 胃肠病学 胃肠病学
- 内镜治疗治疗的目的是.
- 巴雷特的食道管理管理.
背景情况:
- 有限的长期数据存在于射频除 (RFA) 预防食道腺癌的长段 (LSBE) 和超长段巴雷特食道 (ULSBE).
- 评估RFA的10年持久性对于管理这些前恶性疾病至关重要.
研究的目的:
- 评估用RFA治疗的LSBE和ULSBE患者的10年癌症进展,根除和并发症率.
- 为了比较10年来LSBE和ULSBE患者之间的RFA的疗效和安全性.
主要方法:
- 一个单个外科医生前数据库的LSBE (≥3至<8厘米) 和ULSBE (≥8厘米) 患者治疗RFA (2001-2021) 的回顾性分析.
- 卡普兰-梅尔分析用于计算10年癌症进展率.
- 在LSBE和ULSBE组之间比较了清除率 (完全缓解发育不良症[CR-D]和肠道代谢症[CR-IM]),复发率和并发症率.
主要成果:
- 10年后,56名患者的癌症发病率为14.3%. CR-D和CR-IM的利率分别为87.5%和67.9%.
- 在LSBE和ULSBE之间,发育不良的根除率相似 (90.6%与83.3%),但在ULSBE中,肠道代谢的根除更困难 (71.9%与62.5%).
- 组间的并发症 (狭窄,穿孔,出血) 发生率相似;较短的巴雷特细分和基线低度形预测更好的根除.
结论:
- 射频除证明了持续10年的疗效,维持LSBE和ULSBE的乳腺发育不良和肠道代谢除,并可接受的并发症率.
- 与LSBE相比,在ULSBE患者中消灭肠道代谢更具挑战性.
- 在10年的随访期间,14.3%的患者出现了晚期癌症发展.
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