作为对亚皮质病变的初始方法的第二次上部内镜检查:一种令人放心和可靠的战略
Tiago Lima Capela1,2,3, Vítor Macedo Silva1,2,3, Marta Freitas1,2,3
1Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães.
European journal of gastroenterology & hepatology
|February 28, 2024
概括
第二次看上胃肠内镜 (UGE) 可以安全地管理许多亚皮质病变 (SEL),减少进一步侵入性测试的需要. 对于疑似SEL病例,建议采用这种初始的UGE方法.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在上部胃肠道的亚皮质病变 (SEL) 往往需要调查.
- 内镜超声波 (EUS) 是一个关键的工具,但并不总是必要的SEL分类.
- 上部胃肠内镜 (UGE) 有时可能足够,可能减少医疗负担.
研究的目的:
- 评估疑似SEL的逐步诊断方法的影响.
- 在进行EUS之前,评估第二次UGE的实用性.
- 确定初始的UGE是否可以避免需要更先进的调查.
主要方法:
- 怀疑SEL的成年患者的回顾性队列研究 (2015-2020年).
- 详细评估SEL特征 (位置,尺寸,表面等). 在第二次看 UGE 期间.
- 活检和管理/后续决策的收集.
主要成果:
- 在190名患者中分析了193个SEL;胃是最常见的位置.
- 94.7%的患者接受了第二次UGE.
- 大约25%的接受第二次UGE的患者不需要进一步调查,11.7%的患者不需要进一步工作,13.9%的患者被排除在外.
结论:
- 对疑似SEL进行系统的第二次观察UGE方法可以避免在约四分之一的患者中进行后续调查.
- 与EUS相比,UGE的侵袭性较小,并且更容易获得.
- 建议作为管理SEL的初步步骤,推第二次查看UGE.
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