在食道腹腔内镜肌瘤手术过程中,在手术内测光线直径和延伸度测量的实用性
Chiemeziem Eke1, Ian Greenberg1, Bryce Bushe2
1Methodist Digestive Institute, Methodist Dallas Medical Center.
Journal of clinical gastroenterology
|January 16, 2024
概括
口腔内镜肌切除术 (POEM) 为阿喀拉西亚患者提供了持续的临床改善. 根据内光功能光成像探针 (EFLIP) 的发现,手术后的逆流可能与下消化管缩管的延展性有关,而不仅仅是直径.
科学领域:
- 胃肠病学 胃肠病学
- 食道运动障碍 食道运动障碍
- 最少侵入性的手术
背景情况:
- 阿哈拉西亚是一种罕见的食道运动障碍,影响食道下 (LES) 放松和周围静止.
- 口腔内镜肌切除术 (POEM) 是一种有效的治疗 achalasia.
- 症状性酸性反流和食道炎是POEM后已知的并发症.
研究的目的:
- 为了评估阿喀拉西亚的POEM临床反应.
- 为了确定POEM后反流的发生率.
- 评估内膜功能光成像探针 (EFLIP) 在评估 LES 动态和预测反流中的作用.
主要方法:
- 对168名接受POEM治疗阿喀拉西亚的患者进行了回顾性审查.
- 利用EFLIP评估肌肉切除术前后的LES动态.
- 记录了手术前后的埃卡德特症状得分.
主要成果:
- 超过94%的患者在POEM后1年表现出持续的临床改善.
- 在5%的病例中,EFLIP影响了程序内管理 (肌瘤延伸).
- 在POEM后的反流与较高的LES延展度指数 (DI) 有显著的相关性,而不是LES直径.
结论:
- POEM是一种安全有效的治疗症状性头痛症.
- 过程内EFLIP测量表明,LES延展性指数 (DI) 是POEM后逆流的一个关键因素.
- 需要进一步的研究来证实DI和POEM后逆流之间的相关性.
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