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磁力缩器增大术的长期结果:与尼森基层复合进行比较的研究
Kelly E Daus1, Alexander S Farivar1, Adam J Bograd1
1Division of Thoracic Surgery, Swedish Medical Center, Seattle, Washington.
The Annals of thoracic surgery
|September 21, 2024
概括
磁性缩器增大 (MSA) 提供与尼森缩 (NF) 相比的长期GERD缓解,特别是在与完整的缺口修复相结合时. 然而,MSA在没有完全剖析的情况下显示出更高的再手术和的复发率.
科学领域:
- 胃肠病学和外科创新的创新
- 临床结果的比较研究研究
背景情况:
- 在短期研究中,磁性缩器增大 (MSA) 对胃食道逆流性疾病 (GERD) 显示出前景.
- 对于MSA的长期数据有限,缺乏与尼森基底复合 (NF) 的直接比较.
研究的目的:
- 为了比较磁力膜增大 (MSA) 与尼森膜复合 (NF) 治疗GERD的长期疗效和安全性.
- 评估包括生活质量,药物使用和手术并发症在手术后1年和5年的结果.
主要方法:
- 追溯倾向匹配的354名患者 (177名MSA,177名NF) 的队列研究,在2012-2018年间接受了GERD手术.
- 患者的年龄,性别,BMI,椎间的大小,巴雷特食道长度和运动性都与患者匹配.
- 评估的结果包括GERD特异性生活质量评分,PPI使用,pH测试,内扩张,重新手术和的复发.
主要成果:
- 一年后,MSA和NF都显著改善了GERD生活质量得分,两组之间没有显著差异.
- 5年后,两人的生活质量保持稳定,但MSA显示了更高的重复手术率 (10%vs4%) 和复发性间歇性 (18%vs7%).
- 当MSA包括完整的间隙解剖时,扩张,重新手术和的复发的结果与NF相似.
结论:
- 磁力膜增大 (MSA) 提供了与尼森膜增大 (NF) 相似的长期生活质量和免于医疗治疗的自由.
- 在MSA期间进行完整的缺口修复可以减轻在无匹配的分析中观察到的重新手术和的复发风险的增加.
- MSA是NF的可行的替代品,特别是当使用综合性手术技术时.
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