概括
对于符合条件的结肠病变,内镜粘膜切除 (EMR) 导致与手术相比,死亡率和医疗保健利用率显著降低,在美国的一家大型实践中. 这项研究强调EMR是一种潜在的更安全,更具成本效益的治疗选择.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 内镜粘膜切除 (EMR) 是符合条件的结肠病变的标准,但其在美国大人口中的现实表现尚未得到充分证实.
- 将EMR与手术进行比较对于优化社区实践中患者护理和资源配置至关重要.
研究的目的:
- 为了比较结肠EMR和手术切除之间的医疗和医疗保健利用结果.
- 评估EMR的安全性和有效性与社区环境中符合条件的结肠病变手术相比.
主要方法:
- 在2008年至2017年期间接受结肠EMR或手术的患者的回顾性队列研究.
- 主要结局:全因死亡率. 二次结果:复发率和医疗保健利用率.
- 随访时间:平均4.5年.
主要成果:
- 该研究包括EMR组的568名患者和手术组的2054名患者.
- 在EMR组,所有原因的死亡率显著降低 (HR,0.31;P < .0001).
- 所有评估的医疗保健利用指标在EMR队列中都明显较低 (P < .0001).
结论:
- 在社区实践中,适合病变的结肠EMR与所有原因死亡率显著降低有关.
- 与外科手术相比,EMR还导致医疗保健利用率大幅下降.
- 这些发现支持EMR作为选择性结肠病变的有利治疗选择.
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