无道的口腔内镜肌瘤切除减少了手术时间,并保持了Zenker的分离器中的疗效
Georgios Mavrogenis1, Maria Zachou1, Ioannis Tsevgas1
1Unit of Hybrid Interventional Endoscopy, Department of Gastroenterology, Mediterraneo Hospital, Athens, Greece (Georgios Mavrogenis, Maria Zachou, Ioannis Tsevgas, Konstantinos Markoglou, Dimitrios Zachariadis).
Annals of gastroenterology
|September 6, 2024
概括
对于Zenker的分离器 (ZD),修改的口腔内镜肌切除术 (Z-POEM) 技术更快,更安全. 与标准Z-POEM相比,无道Z-POEM显著减少了手术时间.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 内镜检查是指内镜检查.
背景情况:
- 禅克的分泌管 (ZD) 是一种影响食道上部的疾病.
- 口腔内镜肌切除术 (Z-POEM) 是一种成熟的治疗方法.
- 在Z-POEM中的程序变化可能会影响结果.
研究的目的:
- 为了比较修改的Z-POEM技术的程序时间,安全性和临床成功,与Zenker的分离器治疗的标准Z-POEM进行比较.
- 评估单道 (ST Z-POEM) 和无道 (TF Z-POEM) 方法的有效性.
主要方法:
- 对20名患有ZD的患者进行了回顾性,单中心研究.
- 标准Z-POEM (2道) 与修改的ST Z-POEM和TF Z-POEM的比较.
- 所有手术都涉及隔膜上的粘膜切除和2厘米深的食道肌切除.
主要成果:
- 平均程序时间:45分钟 (标准),33分钟 (ST) 和30分钟 (TF Z-POEM).
- 与标准Z-POEM相比,TF Z-POEM的程序时间在统计学上显著减少 (P=0.014).
- 100%的技术成功,平均住院时间为1.3天,不良事件发生率为5%. 所有患者都取得了临床成功.
结论:
- 修改的Z-POEM技术 (ST和TF) 是可行的和安全的ZD治疗.
- 与标准Z-POEM相比,这些修改后的方法显著减少了程序时间.
- 需要进一步的前性研究来证实这些好处在更大的患者队列中.
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