手术前症状持续时间是否会影响口腔内镜肌肉切除术 (POEM) 后的结果?
Jamie Benson1,2, Christina S Boutros3,4, Saher-Zahra Khan3,4
1Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7, Cleveland, OH, 44106, USA. Jamie.Benson@UHhospitals.org.
Surgical endoscopy
|July 12, 2024
概括
在阿喀拉西亚口腔内镜肌切除术 (POEM) 之前,症状持续时间较长不会影响治疗成功. 这项研究发现,患有长期症状的患者中,POEM失败的风险没有增加.
科学领域:
- 胃肠病学 胃肠病学
- 胃肠内镜检查 胃肠内镜检查
- 手术创新 在外科创新.
背景情况:
- 阿哈拉西亚是一种运动障碍,可以导致食道的解剖变化,并带来长时间的症状.
- 通过口腔内镜肌切除术 (POEM) 是一种成熟的,安全的治疗 achalasia.
- 秋症症状持续时间对POEM结果的影响需要进一步调查.
研究的目的:
- 调查阿喀拉西亚症状的持续时间与口腔内镜肌切除术 (POEM) 的结果之间的关联.
- 为了确定长期的阿喀拉西亚是否会影响POEM成功率和患者康复.
主要方法:
- 在2011年至2023年期间,对234名接受POEM治疗的阿喀拉西亚患者进行了回顾性分析.
- 患者被分为四个症状持续时间队列:<1年,1-3年,4-10年和>10年.
- 结果包括手术前后的埃卡德得分,症状复发,以及需要重新干预的结果,通过使用多变量逻辑回归来对整个队列进行了比较.
主要成果:
- 在症状持续时间队列中,没有观察到患者人口统计,手术前测量或基线症状严重程度 (埃卡德得分) 的显著差异.
- 症状超过4年的患者有更多的先前内镜干预 (68%对37%).
- 在所有症状持续时间组中,POEM后的结果,包括埃卡德得分,症状复发和需要重复干预的情况都相似. 长期症状 (>10年) 并没有增加不良结果的几率.
结论:
- 在阿喀拉西亚患者中,症状持续时间较长似乎与POEM失败率的增加无关.
- 无论患者经历了多长时间的阿喀拉西亚症状,POEM都显示出一致的疗效.
- 这些发现支持POEM作为一种有效的治疗选择,即使是患有长期疾病的患者.
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