与胃内镜下粘膜切割相关的手术内和延迟穿孔的危险因素
Takuya Mimura1, Yoshinobu Yamamoto1, Haruhisa Suzuki2,3
1Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan.
Journal of gastroenterology and hepatology
|April 1, 2024
概括
穿孔是早期胃癌 (EGC) 的内镜下粘膜切割 (ESD) 的关键并发症. 这项研究确定了手术内和延迟穿孔的风险因素,以帮助内镜医生尽量减少风险.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 医疗并发症 医疗并发症
背景情况:
- 穿孔是早期胃癌 (EGC) 的内镜下粘膜解剖 (ESD) 的重要并发症.
- 之前关于穿孔风险因素的研究大多是回顾性,患者数量有限.
- 了解这些风险对于改善ESD程序期间的患者安全至关重要.
研究的目的:
- 调查EGC的ESD期间与手术内和延迟穿孔相关的风险因素.
- 提供来自大型,前性,多中心队列的数据,以告知临床实践.
- 确定增加穿孔风险的特定患者和程序因素.
主要方法:
- 日本多中心前性队列研究的二次分析.
- 包括在2010年7月至2012年6月期间接受ESD的9975个EGC.
- 统计分析以确定手术内和延迟穿孔的独立风险因素.
主要成果:
- 在2.2%的病变中发生了手术内穿孔,风险因素包括胃上部/中部位置,胃残留,更长的手术时间,更大的瘤大小,较低的BMI和更高的年龄.
- 延迟穿孔发生在0.4%的病变中,风险因素包括更长的手术时间,较低的BMI,年龄较大,,以及较大的瘤大小.
- 特定位置,如胃上部/中部较大的曲,与分别更高的手术内/延迟穿孔率有关.
结论:
- 本研究阐明了风险,并确定了EGC的ESD中手术内和延迟穿孔的关键风险因素.
- 这些发现为内镜师提供了宝贵的信息,以减轻穿孔风险.
- 前性数据突出了患者和程序特征在穿孔发生的重要性.
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