一把鹿刀可以在食道中实现更稳定,更安全的内镜下膜剖析
Kohei Funasaka1, Noriyuki Horiguchi1, Hyuga Yamada1
1Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Japan.
Endoscopy international open
|December 14, 2023
概括
鹿甲虫 (SB) 刀提供了一种更安全的方法,用于食道内镜下粘膜剖析 (ESD),与尖端类型刀相比,显著减少肌肉暴露. 这种剪刀类型的设备在食道ESD程序中显示出更好的安全性.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 手术技术 手术技术
背景情况:
- 食道内镜下粘膜切割 (ESD) 的并发症率高于胃ESD.
- 剪刀类型的设备,如鹿甲虫 (SB) 刀,被建议比ESD的尖端类型的设备更安全和更有效.
- 在食道ESD中SB刀的安全性和有效性需要进一步澄清.
研究的目的:
- 为了比较食道ESD的治疗结果,使用尖型刀与SB刀组合.
- 为了评估两种设备类型之间的手术时间,并发症率和肌肉暴露.
- 在食道ESD期间识别与肌肉暴露相关的风险因素.
主要方法:
- 从2016年1月至2023年3月期间接受食道ESD的178名患者 (197病变) 的临床数据的回顾性分析.
- 病变被分类为尖端类型或SB组,基于最初的粘膜下切割装置.
- 使用多变量分析来评估肌肉暴露的风险.
主要成果:
- 尖端类型和SB刀组之间的手术时间相似 (60.3±42.2分 vs. 58.8±29.1分),但差异很大 (P=0.002).
- 与尖型刀 (24.5%,P=0.016) 相比,SB刀的肌肉暴露发生率明显较低 (11.1%),特别是在切除的标本>21毫米.
- 较长的手术时间 (>60分钟) 是肌肉暴露的风险因素 (OR2.5),而SB刀的使用是安全因素 (OR0.4).
结论:
- 用SB刀进行食道ESD是一种安全的程序.
- SB刀导致手术时间变化较少,肌肉暴露减少.
- 使用SB刀提高了食道内镜下粘膜切割的安全性.
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