在POEM期间保护丝纤维可以减少术后逆流症状的发生率
Yusuke Fujiyoshi1,2, Mary Raina Angeli Fujiyoshi1,2, Kareem Khalaf1
1Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
概括
在口腔内镜肌肉切除 (POEM) 期间带纤维的保存显著降低了西方患者的术后胃食道逆流病 (GERD). 这种技术为POEM程序后的GERD管理提供了一个有希望的解决方案.
科学领域:
- 胃肠病学和内镜检查
- 手术技巧 手术技巧
- 逆流性疾病管理管理
背景情况:
- 胃食道逆流病 (GERD) 是口腔内镜肌切除术 (POEM) 后的一个显著限制.
- 之前在日本进行的研究表明,在POEM期间保存带纤维可以减轻术后GERD.
- 这种特定技术在西方人群中的有效性仍有待研究.
研究的目的:
- 评估POEM期间带纤维保存在减少西欧患者队列中手术后GERD症状的有效性.
- 为了比较常规POEM和POEM与吊带纤维保护之间的反流症状发生率,临床成功率,手术时间和不良事件.
主要方法:
- 这是一项回顾性,单中心研究,涉及148名在2017年10月至2023年1月期间接受POEM的患者.
- 患者被分为两组:常规的POEM和POEM与吊带纤维保存.
- 评估的结果包括术后逆流症状,临床成功 (埃卡德得分≤3),手术持续时间和不良事件. 使用多变量回归分析来确定GERD的风险因素.
主要成果:
- 护带纤维保存组的术后逆流症状发生率明显较低 (22.4%对42.3%,P <0.05).
- 虽然胃肌切除术的长度在保存组中较长 (2.2 ± 0.7厘米与1.6 ± 0.8厘米相比,P <0.05),但手术时间和不良事件发生率在各组之间相似.
- 多变量回归证实,带纤维的保存是一种独立的反流症状保护因素 (几率比:0.24,95% CI:0.07-0.85,P <0.05).
结论:
- 在POEM期间带纤维的保存是一种有效的技术,可以减少西方患者手术后GERD症状的发生率.
- 这种修改后的POEM方法保持了与传统POEM相比的临床成功和安全性.
- 带纤维的保存是改善结果和管理POEM后的GERD的一个有价值的策略.
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