肌肉损伤是整个周围食道内镜下粘膜解剖后结构的危险因素
Daisuke Azuma1, Kingo Hirasawa1, Reo Atsusaka1
1Division of Endoscopy, Yokohama City University Medical Center, Yokohama, Japan.
Digestive diseases (Basel, Switzerland)
|February 3, 2025
概括
在食道内镜下粘膜解剖 (ESD) 过程中肌肉损伤增加了耐火性狭窄的风险. 预防肌肉损伤对于改善整个周围食道ESD (EC-E-ESD) 后的患者结果至关重要.
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
- 在瘤学瘤学.
背景情况:
- 内镜下粘膜切割 (ESD) 是早期食道癌的标准治疗方法.
- 在ESD后的广泛的粘膜缺陷可能导致食道狭窄,影响生活质量.
- 整个周围食道ESD (EC-E-ESD) 后的耐火性狭窄症是一个重大的临床挑战.
研究的目的:
- 为了确定EC-E-ESD后耐火性狭窄的危险因素.
- 评估临床病理特征与耐火性狭窄发育之间的关联.
- 为预防术后食道狭窄的策略提供信息.
主要方法:
- 在2013年7月至2023年9月期间接受EC-E-ESD治疗的49名患者的回顾性分析.
- 根据扩张要求,患者被分为耐火性和非耐火性狭窄症组.
- 使用多变量逻辑回归分析来确定独立的风险因素.
主要成果:
- 耐火性狭窄发生在51%的患者身上.
- 肌肉损伤 (52%对8%) 和更大的粘膜缺陷长度 (≥50毫米) 在耐火组显著更高.
- 肌肉损伤被确定为耐火性狭窄的独立风险因素 (OR 16.2).
结论:
- 在EC-E-ESD期间肌肉损伤是发展耐火性狭窄症的重要危险因素.
- 目前的预防措施不足,需要进一步研究预防策略.
- 精细的剖析技术和优化的类固醇管理可以帮助减轻这种风险.
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