在Zenker转和下食道病理学 (POUCH协作) 中的手术不响应者
Johnathan Brown1, Nicole McCoy1, Jacqui Allen2
1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
The Laryngoscope
|July 9, 2024
概括
在患有间歇性的患者中,Zenker Diverticulum手术可能不会改善症状. 建议对非响应者进行进一步的食道评估,以确定手术结果差的潜在原因.
科学领域:
- 胃肠病学 胃肠病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术研究的研究.
背景情况:
- 禅克转 (ZD) 是一种罕见的疾病,需要手术干预.
- 在ZD手术后症状的改善有所不同,一些患者经历了糟糕的结果.
- 确定手术反应不佳的预测因素对于优化患者护理至关重要.
研究的目的:
- 为了确定与Zenker Diverticulum手术后不最佳症状改善相关的患者特征.
- 根据客观措施,区分手术响应者 (SR) 和手术不响应者 (SNR).
主要方法:
- 一项前性多中心队列研究 (POUCH协作) 包括184名接受ZD修复的患者.
- 术前和术后的饮食评估工具 (EAT-10) 评分被用来定义SRs (≥50%的改善) 和SNRs (<50%的改善).
- 统计分析比较了SR和SNR之间的人口和临床特征.
主要成果:
- 12%的患者被确定为手术不响应者 (SNR).
- 在SNR (63.6%) 与SR (32.1%) (p=0.004) 相比,SNR中术前缺口的存在明显更为常见.
- ZD大小和之前的ZD手术史没有显著预测手术结果;停留时间和并发症在各组之间是相似的.
结论:
- 同时存在的食道病理,如间歇性,可能会导致ZD手术后症状不佳.
- 建议对其他食道疾病进行手术前查,以确定潜在的手术不响应者.
- 对于患有ZD手术后持续症状的患者,需要进一步调查食道原因.
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