大型直肠瘤内镜下粘膜解剖后缩的危险因素
Daniel T Rezende1, Fabio S Kawaguti1,2, Cintia M S Kimura3,4
1Division of Endoscopy, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.
在内镜下膜剖析后的直肠狭窄与大缺陷 (≥90%的周长) 有关. 大多数症状性狭窄症通过扩张得到解决,突出了关键的风险因素和成功的治疗策略.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 内镜手术 进行内镜手术
背景情况:
- 在内镜下粘膜切割 (ESD) 后的急性不良事件,如穿孔和出血,已得到充分记录.
- 专注于ESD后狭窄的研究是有限的,需要进一步调查风险因素和结果.
研究的目的:
- 确定与ESD后直肠收缩和症状收缩相关的风险因素.
- 为了评估患者的结果,包括治疗疗效,在西方三级癌症中心.
主要方法:
- 一个单一中心的回顾性研究,使用前性收集的直肠ESD程序数据库.
- 分析包括94名在2010年7月至2020年1月期间因直肠瘤接受ESD治疗的患者.
- 评估了狭窄发育的风险因素,并将狭窄分类为完全或部分.
主要成果:
- 在94名患者中,有20名患者 (21.3%) 患有直肠狭窄 (13名完全,7名部分).
- 多变量分析确定了90%以上的外围粘膜缺陷是狭窄的唯一显著风险因素 (p < 0.001).
- 完全狭窄的13名患者中有11名有症状,并通过连续扩张 (平均7.8次) 成功治疗.
结论:
- 广泛的外围粘膜缺陷 (≥90%) 是ESD后直肠收缩的重要危险因素.
- 在ESD后出现的症状性直肠收缩可以通过内镜扩张有效管理.
- 这项研究为西方人口管理后ESD狭窄提供了有价值的见解.
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