结直肠内镜下粘膜剖析技术困难相关的预测因素:霍纳姆肠道疾病研究协会 (HASID) 多中心研究
Hyung-Hoon Oh1, Yong-Wook Jung1, Byung-Chul Jin2
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Medicine
|April 26, 2024
概括
确定了难以进行结直肠内镜下膜剖析 (ESD) 的预测因素. 较大的瘤,中心病变和先前的手术增加了技术困难,有助于对这种具有挑战性的胃肠道手术进行程序前规划.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 在瘤学瘤学.
背景情况:
- 结肠直肠内镜下粘膜切割 (ESD) 是一种复杂的程序,由于技术挑战,其采用程度有限.
- 识别预测程序困难的因素对于改善结果和可访问性至关重要.
研究的目的:
- 确定与结直肠ESD技术困难相关的术前预测因素.
- 加强规划,并可能减少结直肠ESD期间的并发症.
主要方法:
- 从5家医院 (2015-2020年) 接受结直肠ESD的1446名患者的临床数据的回顾性分析.
- 由手术时间 (>60分钟),穿孔或阻断切除失败所定义的技术困难.
- 统计分析以确定与困难的ESD和穿孔相关的因素.
主要成果:
- 16.0%的手术在技术上很困难,2.3%的手术导致穿孔,89.3%的手术实现了块切除.
- 预测困难的因素包括瘤大小>35mm,中央病变抑制/,以及先前的内镜粘膜切除 (EMR) 或多角切除术.
- 下降结肠位置和使用IT刀与穿孔有关.
结论:
- 在程序前确定特定的瘤和患者因素可以预测结直肠ESD的技术困难.
- 了解这些因素可以更好地规划程序,从而提高安全性和有效性.
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