额外的超视镜剪贴关闭可以缩短术后上部胃肠道泄漏的内镜真空治疗
Lars Kollmann1, Alexander Weich2, Maximilian Gruber1
1Department of General, Visceral, Transplantation, Vascular, and Pediatric Surgery, University Hospital Wurzburg, Wurzburg, Germany.
Endoscopy international open
|September 12, 2024
概括
在内镜真空疗法 (EVT) 后添加超范围剪贴 (OTSC) 可以显著缩短上部胃肠道泄漏的治疗时间. 这种综合方法使得患者能够更早地出院,并改善营养结果.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 治疗创新 治疗创新
背景情况:
- 内镜真空疗法 (EVT) 对上部胃肠道泄漏非常有效,但通常需要长时间住院治疗.
- 优化EVT协议对于改善患者康复和减少医疗负担至关重要.
研究的目的:
- 评估EVT后应用超范围剪贴 (OTSC) 是否可以减少泄漏治疗的总体持续时间.
- 评估EVT与OTSC结合对患者出院时间和功能结果的影响.
主要方法:
- 一项倾向匹配的队列研究,将接受EVT与OTSC治疗的患者与单独接受EVT治疗的患者进行比较,用于上部胃肠道泄漏.
- 主要终点的分析:从泄漏诊断到出院的时间.
- 二级终点包括治疗疗效,并发症率和营养状况.
主要成果:
- 与单独使用EVT相比,EVT和OTSC的组合显著减少了离院的时间 (33天与46天相比).
- EVT+OTSC组显示不需要额外的手术,而仅使用EVT组的12%需要支架.
- 在EVT+OTSC组中,有更高比例的患者在获得足够的口服营养后出院 (98%vs60%).
结论:
- 在成功EVT后添加OTSC是一种安全有效的策略.
- 将EVT与OTSC结合起来可以缩短泄漏治疗的持续时间,促进更早的出院和更好的功能恢复.
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