在口腔内镜肌切除术 (POEM) 后对术后食道图的评估
Jamie Benson1,2, Christina Boutros3,4, Saher-Zahra Khan3,4
1Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. Jamie.Benson@UHHospitals.org.
Surgical endoscopy
|July 22, 2024
概括
经过口腔内镜肌切除术 (POEM) 后,对于阿喀拉西亚的例行术后食管图是不必要的. 这项研究发现结果没有显著差异,这表明成像应该基于临床症状,而不是常规实践.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 手术后食管图用于检测上部胃肠道手术后的泄漏,包括口腔内镜肌切除术 (POEM).
- 然而,在POEM之后,它们的常规使用不是标准化的,通常是基于外科医生的自由裁量权.
- 来自肌肉切割部位的泄漏是POEM后的一个重大并发症.
研究的目的:
- 评估在接受POEM治疗阿喀拉西亚患者的例行术后对照食道图的必要性.
- 为了确定常规食管图是否会影响并发症率,停留时间或再入院率.
主要方法:
- 在2011年至2022年期间接受POEM的277名阿喀拉西亚患者的回顾性审查.
- 分析了符合纳入标准的173名患者,将接受术后食管图的人与没有接受术后食管图的人进行了比较.
- 收集了关于泄漏,整体并发症,停留时间和再接收率的数据,并使用Stata.
主要成果:
- 在早期的术后期,在食管图组中发现了三次泄漏,而在非食管图组中没有发现任何泄漏.
- 整体并发症率为7.9% (食食图) 和5.5% (非食食图).
- 住院时间为1.76天 (食食图) 与1.48天 (非食食图),再接收率为8.7% (食食图) 与10.9% (非食食图).
结论:
- 在接受术后食管图和未接受术后食管图的患者之间没有观察到统计学上显著的结果差异.
- 在POEM后常规使用对比食谱来检测泄漏可能是不合理的.
- 手术后食管图应保留给表现出需要成像和潜在干预的临床迹象或症状的患者.
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