重复内镜下粘膜切割接近最初的内镜下粘膜切割痕表面食道状细胞癌
Koki Matsuoka1, Tsukasa Ishida2, Tetsuya Yoshizaki3
1Department of Gastroenterology, Akashi Medical Center, 743-33 Yagi Okubo-Cho, Akashi, Hyogo, 747-0063, Japan.
概括
重复内镜下粘膜切割 (ESD) 对食道状细胞癌在以前的痕附近复发是有效的. 这种手术的结果和生存率与最初的ESD相似,尽管穿孔风险略高.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 手术内镜是指手术内镜.
背景情况:
- 食道状细胞癌 (ESCC) 在先前内镜下粘膜切割 (ESD) 痕附近的超慢性复发是一个治疗挑战.
- 对复发性ESCC重复ESD的疗效和安全性进行评估对于患者管理至关重要.
研究的目的:
- 评估重复ESD的临床结果和安全性,以评估ESCC复发的临床结果和安全性,并与之前的ESD地点相邻.
- 将这些结果与初级ESD程序的结果进行比较.
主要方法:
- 一项回顾性研究涉及1680名接受ESD治疗ESCC的患者.
- 倾向性得分匹配被用来比较重复ESD组 (n=91) 和首次ESD组 (n=910) 的结果.
- 卡普兰-梅尔分析和日志等级测试评估了生存率和局部复发率.
主要成果:
- 两组之间在块切除率,治疗持续时间,复发率或收缩率方面没有发现显著差异.
- 重复ESD组表现出明显更高的穿孔率 (4.40%对1.10%,p=0.031).
- 五年整体生存率是可比的 (88.6%和89.0%).
结论:
- 在初始痕附近复发ESCC的重复ESD表明了令人满意的临床结果和存活率.
- 重复ESD是一种可行和有效的治疗选择,用于在具有挑战性的位置管理ESCC复发.
- 在重复的ESD手术中,需要仔细考虑穿孔风险的增加.
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