在准食道修复时进行的基囊复合并不会降低的复发率或术后逆流率
Joshua Lyons1,2,3, Hamza Nasir Chatha4,5,6, Christina Boutros4,5,6
1Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7, Cleveland, OH, 44106, USA. Joshua.Lyons@UHHospitals.org.
Surgical endoscopy
|October 24, 2024
概括
在准食道 (PEH) 修复过程中进行基复合并没有防止复发或GERD,但增加了失. 在没有手术内异常的情况下,不支持用于PEH修复的常规使用.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 副食道 (PEH) 修复旨在缓解症状并防止复发.
- 基金复合有时与PEH修复同时进行,以减轻胃食道逆流 (GERD) 和复发.
- 在PEH修复过程中支持常规基复合的证据仍然有限.
研究的目的:
- 评估PEH修复期间的基底复合的有效性和并发症.
- 为了比较PEH修复与没有基囊复合之间的复发,重复手术,消化不良和GERD的发生率.
主要方法:
- 从2010年至2023年进行PEH修复的1,155名患者的回顾性队列研究.
- 患者被分为两组:那些经过基囊切除的人和那些没有经过基囊切除的人.
- 评估的结果包括PEH复发,重新手术率,以及手术后的消化不良和GERD.
主要成果:
- 在610名患者 (53%) 进行了基囊移植,而545名 (47%) 患者没有接受手术.
- Hernia 复发发生在 19% 的 fundoplication 组,而非 fundoplication 组的 12% (p=0.004).
- 经手术后的消化不良症在基底复合时更高 (12%对7%,p=0.002),而在GERD发病率上没有差异 (7%对7%,p=0.93).
结论:
- 在PEH修复过程中进行基复合并没有减少的复发,重新手术率或术后GERD.
- 这种手术与术后食障碍的发病率增加有关.
- 在胃食道门在手术期间看起来正常时,不建议在PEH修复过程中进行常规的基囊复合.
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