结直肠上皮瘤的内镜下膜剖析后的长期结果,在患有严重并发症的患者中
Yasuhiko Hamada1, Yohei Ikenoyama1, Yuhei Umeda1
1Department of Gastroenterology and Hepatology Mie University Hospital Tsu Japan.
概括
对于结直肠上皮瘤 (CENs) 的内镜下粘膜剖析 (ESD) 后的长期结果显示,患有严重并发症的患者的生存率降低. 对这些接受CENESESESD治疗的患者来说,仔细的风险益处评估至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床结果研究研究
背景情况:
- 在患有严重并发症的患者中,对结直肠上皮瘤 (CEN) 进行内镜下粘膜剖析 (ESD) 的长期结果尚不清楚.
- 这项研究比较了患有严重和不严重并发症的患者之间CEN的长期ESD结果.
研究的目的:
- 评价和比较ESD的长期结果,用于CENs在患者的严重与非严重的并发症.
- 为临床决策提供有关ESD在高危患者群体中的风险和益处的信息.
主要方法:
- 一项回顾性研究包括231名接受CENESESD的患者.
- 患者根据美国麻醉师协会身体状况 (ASA-PS) 评分进行分类.
- 倾向性得分匹配分析比较了严重 (ASA-PS III) 和非严重 (ASA-PS I/II) 同病症组之间的结果.
主要成果:
- 在匹配后,36名患有严重并发症的患者与36名患有非严重并发症的患者进行了比较.
- 没有观察到程序结果的显著差异.
- 严重并发症的五年总生存率为73.5%,而非严重的并发症为100% (HR 7.209,P=0.010).
- 在这两组中都没有发生与结直肠癌相关的死亡.
结论:
- 在CEN患者的ESD后的整体存活期在患有严重并发症的患者中显著较短.
- 临床医生必须仔细权衡ESD的好处与严重并发症患者的程序风险.
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