水下 VS 水下 传统的内镜下粘膜解剖:来自德国高容量中心的回顾性分析
Mousa Ayoub1,2, Sandra Nagl2, Anna Muzalyova3
1Department of Medicine I, Katholisches Klinikum Bochum Sankt Josef-Hospital, Bochum, Germany.
Zeitschrift fur Gastroenterologie
|August 4, 2025
概括
水下内镜下粘膜剖析 (uESD) 与常规ESD (cESD) 对于胃肠道新生病一样有效和安全. 这两种方法都显示出高的成功率和低的并发症风险,uESD为未来的研究提供潜在的手术内益处.
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) 是早期胃肠道瘤的标准技术.
- 水下ESD (uESD) 或盐水浸泡治疗内镜 (SITE) 是一种修改,旨在改善粘膜下通道并减少出血并发症.
研究的目的:
- 评估uESD与传统ESD (cESD) 相比在德国的有效性和安全性.
- 提供德国队列中关于uESD表现的初步数据.
主要方法:
- 追溯分析72名接受uESD (n=36) 或cESD (n=36) 的患者.
- 倾向性得分匹配用于确保组之间可比的损伤位置和大小.
- 分析的关键结局包括手术时间,并发症率,en-bloc切除,R0切除和复发率.
主要成果:
- uESD和cESD都实现了100%的区块切除率和高的R0切除率 (uESD为94.4%,cESD为91.7%).
- 程序时间相似 (uESD的中位数为77分钟,cESD的中位数为75分钟).
- 并发症的发生率较低且可比,在uESD组有1次收缩,在cESD组有2次出血;没有发生穿孔.
结论:
- 水下ESD (uESD) 的有效性和安全性与传统的ESD (cESD) 相同.
- 这两种技术都带来了高的技术和临床成功,并发症最小.
- 进一步的前性研究是有必要的,以探索uESD的潜在的手术内优势,如更快的下内进入和减少出血.
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