手术与食道穿孔的内镜治疗对比
Kevin J Wang1, Evelyn V Alexander, Stephanie G Worrell
1Division of Cardiothoracic Surgery, Department of General Surgery, University of Arizona-Tucson, Tucson, Arizona, USA.
Current opinion in gastroenterology
|April 30, 2025
概括
食道穿孔的管理现在包括内镜选项与手术一起. 考虑到患者因素和穿孔类型的量身定制方法对于治疗这种疾病的最佳结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
- 医学创新 医学创新
背景情况:
- 食道穿孔的管理历来依赖于手术,往往导致患者显著的发病率.
- 随着外科手术和内镜干预的进步,当代治疗策略正在不断发展.
研究的目的:
- 探索和审查当前对食道穿孔的管理选择.
- 为了比较与外科手术和内镜治疗相关的疗效和患者结局.
主要方法:
- 对食道穿孔的内镜疗法最近的创新进行了审查.
- 分析支持患者特异性治疗方法的证据.
- 基于穿孔特征的手术和内镜干预之间的结果比较.
主要成果:
- 内镜疗法,包括支架和剪贴,为选择早期的,封闭的穿孔提供了降低的发病率和更短的住院时间.
- 对于广泛的污染,亡或延迟诊断,外科干预仍然至关重要.
- 整合各种干预措施的患者特定方法越来越多地得到证据的支持.
结论:
- 最少侵入性的内镜技术正在扩大食道穿孔的治疗可能性.
- 对于血液动力学不稳定的患者或患有广泛污染的患者来说,手术修复是最终的.
- 基于个体患者因素和疾病表现的及时,量身定制的干预措施对于最佳结果至关重要.
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