在POEM期间用于食道运动障碍的横向与纵向粘膜切口:一种随机试验
Jayendra Shukla1, Harshal S Mandavdhare2, Jimil Shah1
1Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Surgical endoscopy
|July 15, 2024
概括
这项研究发现,口腔内镜肌切除术 (POEM) 切口时间或纵向和横向切口之间与气体有关的事件没有显著差异. 这两种方法在治疗食道运动障碍时同样有效.
科学领域:
- 胃肠病学 胃肠病学
- 手术内镜是指手术内镜.
- 最少侵入性手术的方法
背景情况:
- 口腔内镜肌切除术 (POEM) 通常使用纵向切口进行亚粘膜入口.
- 横切口是另一种选择,先前的数据表明,在操作时间和减少与气体有关的事件方面,有潜在的好处.
研究的目的:
- 为了比较纵向与横向切口的疗效和安全性,在POEM中进行下粘膜入口.
- 主要终点:进入粘膜下空间的时间.
- 二级终点:切口关闭时间,需要的剪贴和与气体有关的事件.
主要方法:
- 单中心随机试验涉及患有食道运动障碍的患者接受POEM.
- 患者被随机分为两组:纵切 (A组) 和横切 (B组).
- 用凯尔西方法计算非劣质设计的样本大小.
主要成果:
- 60名患者 (30人/组) 被随机分配.
- 进入时间 (p=0.399),关闭时间 (p=0.155) 或关闭剪辑数量 (p=0.156) 之间没有观察到显著差异.
- 与气体相关的事件,包括需要吸收的皮 (p=0.228) 和皮下肺 (p=0.301),是相似的.
结论:
- 这项随机试验表明,纵向和横向切口在进入时间,关闭时间,剪贴使用和POEM期间与气体相关事件的发生率方面是可比的.
- 这些发现表明,无论哪种切口类型都可以安全地用于POEM手术.
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