消化管形态不预测口腔内镜肌切除术后的术后结果
Christina S Boutros1,2,3, Catherine A Boutros1,2,3, Jamie R Benson1,2,3
1Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7, Cleveland, OH, USA.
Surgical endoscopy
|July 23, 2025
概括
食道形态不会影响门内镜肌切除术 (POEM) 在阿喀拉西亚的成功. 然而,更宽的食道角可能表明POEM后需要进一步的内镜干预.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 食道疾病 食道疾病
背景情况:
- 口腔内镜肌切除术 (POEM) 是治疗食道运动障碍的领先治疗方法,如.
- 食道形态对POEM结果的影响尚未得到充分证实.
- 关于食道直径或角是否影响POEM成功率或再干预率的数据有限.
研究的目的:
- 为了研究术前食道形态与阿喀拉西亚患者的POEM后结果之间的关联.
- 为了确定食道直径,角或鸟的外观是否预测POEM失败或需要重复干预.
- 评估特定的形态特征是否适用于POEM.
主要方法:
- 88名接受POEM (2012-2024) 的阿喀拉西亚患者的回顾性分析.
- 患者按手术前食道直径,角度和鸟的外观分类通过定时吞.
- 通过重新干预,症状复发或高的术后埃卡德得分来定义POEM失败;使用多变量逻辑回归.
主要成果:
- 食道直径>5厘米与鸟的外观相关 (p<0.05).
- 鸟的外观与更高的术后综合放松压力 (IRP) (p=0.03) 相关,但症状的复发并非如此.
- 增加食道角与需要术后内镜干预显著相关 (p=0.02);直径和鸟不是预测.
结论:
- 食道形态,包括直径和鸟的外观,不会显著影响POEM后的症状复发或重新干预率.
- 增加的食道角可能预测需要术后内镜干预.
- 消化管形态不应被认为是阿喀拉西亚患者POEM的禁忌.
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