食道拉下技术改善了腹腔镜Heller-Dor肌肉切除术在末期阿喀拉西亚的结果
Giulia Nezi1, Francesca Forattini1, Luca Provenzano1
1Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova School of Medicine, Padova, Italy.
概括
与经典的腹腔镜Heller-Dor肌肉切割相比,拉向下拉技术为末期阿喀拉西亚患者提供了更好的结果. 这种修改后的方法在具有挑战性的病例中显著降低了治疗失败率.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
背景情况:
- 与西格性食道相结合的终末阶段阿喀拉西亚带来了重大治疗挑战.
- 下拉技术是一种修改后的方法,用于直食道轴.
- 关于拉下技术的有效性存在有限的研究.
研究的目的:
- 为了比较拉下技术的结果与临床腹腔镜Heller-Dor (CLHD) 骨髓切除术用于末期.
- 为了评估在患者的治疗成功率和失败率sigmoid achalasia.
主要方法:
- 对接受LHD骨髓切割 (1995-2022) 的末期阿喀拉西亚患者的回顾性研究.
- 患者使用症状评分,吞,内镜和手术前后测量仪进行了评估.
- 治疗失败定义为持续/复发的埃卡德得分>3或需要重新治疗.
主要成果:
- 60名患者接受了CLHD骨髓切割,34人接受了拉下技术.
- 整体LHD肌切除术的成功率为82.6% (76/92).
- 与CLHD (27.6%,P <.01) 相比,拉下组 (5.9%) 的失败率明显较低.
- 在CLHD组中,有两名患者 (2.1%) 发展为状细胞癌.
结论:
- laparoscopic Heller-Dor (LHD) 骨髓切除术对于末期的秋拉症是有效的.
- 下拉技术显示出优异的结果和较低的失败率,特别是在难以治疗的病例中.
- 进一步研究拉下技术的长期益处是有必要的.
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