使用可重新打开的剪贴超线方法关闭胃粘膜缺陷,以减少内镜下粘膜剖析后出血的风险:多中心倾向性得分匹配的病例对照研究 (附视频)
Shinya Sugimoto1, Tatsuma Nomura2, Taishi Temma1
1Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan.
Gastrointestinal endoscopy
|November 14, 2024
概括
新的可重开剪贴超线方法 (ROLM) 在内镜下膜解剖 (ESD) 后有效地关闭粘膜缺陷,显著降低了早期胃癌患者手术后出血风险.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 在瘤学瘤学.
背景情况:
- 内镜下粘膜切割 (ESD) 是早期胃癌的关键治疗方法.
- 后ESD出血是一种严重的并发症,目前还没有最佳的闭合方法.
- 在ESD后有效的粘膜缺陷关闭对于减少出血发生率至关重要.
研究的目的:
- 为了评估新开发的剪贴线关闭方法的有效性,重新打开的剪贴线超线方法 (ROLM).
- 评估ROLM在预防ESD后出血的能力.
- 为解决胃ESD后最优的粘膜关闭技术的未满足需求.
主要方法:
- 在2012年1月至2024年3月期间接受胃ESD的患者的回顾性审查.
- 不封闭组与使用ROLM治疗粘膜缺陷封闭的组进行比较.
- 倾向性得分与基线特征和出血风险因素的控制匹配.
主要成果:
- 在倾向得分匹配后,在非闭合和ROLM组中分析了168个病变.
- 在ROLM组中,ESD后出血率明显较低 (1.8%),与非闭合组相比 (7.7%;P = .02).
- 在ESD之后,ROLM成功地实现了粘膜缺陷的完全关闭.
结论:
- 重开式剪贴超线方法 (ROLM) 是一种可行的技术,用于在胃ESD后关闭粘膜缺陷.
- ROLM有效地预防ESD后出血,特别是在高风险患者中.
- 这种方法解决了当前内镜下膜切割管理中的一个关键缺口.
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