在良性阻燃性食道收缩中食道自我扩张:随机对照试验和前性观察研究的结果
Magnus Halland1,2, David O Prichard3,4,5, Allon Kahn6
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Magnus.Halland@newcastle.edu.au.
Digestive diseases and sciences
|May 29, 2024
概括
食道自我扩张疗法 (ESDT) 对于耐火良性食道收缩是有效的,减少了重复手术的需要. 这种安全的疗法赋予了患者权力,并改善了难以治疗的收缩的结果.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 治疗干预 治疗干预
背景情况:
- 耐火性良性食道狭窄症往往无法对扩张或支架等标准治疗做出反应.
- 食道自我扩张疗法 (ESDT) 提供了一种潜在的解决方案,以保持光通率并减少医疗负担.
- 以前的疗法可能无法为患有复杂食道收缩的患者提供持续的缓解.
研究的目的:
- 评估食道自我扩张治疗 (ESDT) 在耐火良性食道狭窄症患者的疗效和安全性.
- 在随机对照试验中,将ESDT结果与标准内镜扩张进行比较.
- 在前性观察性研究中评估ESDT对食障碍的影响以及重复内镜手术的必要性.
主要方法:
- 一项随机对照试验和一项前性观察性研究与25名被诊断患有耐火良性食道收缩的患者进行.
- 在2018年11月至2021年6月期间,在两个专门的食道诊所招募了患者.
- 收集的数据包括内镜扩张的数量,消化不良的严重程度和不良事件.
主要成果:
- 在随机组中,使用ESDT的50%的患者需要进一步进行内镜扩张,而对照组的100% (P=0.02) 需要进一步进行内镜扩张.
- 观察性研究显示,内镜扩张的显著减少,从ESDT前的7个中位数到ESDT后的1个中位数 (P<0.0001).
- 大多数患者 (22/25) 成功学会了ESDT,严重不良事件很少,失足症症状稳定或改善.
结论:
- 食道自我扩张疗法 (ESDT) 是一种安全有效的治疗选择,用于对常规内镜疗法不耐药的良性食道狭窄.
- 通过ESDT,可以显著减少对重复内镜干预的需求,为患者提供可持续的解决方案.
- 这些发现支持ESDT作为一个有价值的工具来管理复杂的食道狭窄,改善患者的自主权,并可能降低医疗保健成本.
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