食道穿孔的内镜治疗:多中心研究
Razan Aburumman1,2, Farah Abdul Razzak3, Anthony Kerbage4
1Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Surgical endoscopy
|August 25, 2025
概括
主要封闭和组合疗法对食道穿孔 (EP) 的治疗非常成功. 早期内镜干预改善了结果,避免了这种罕见的疾病的手术.
科学领域:
- 胃肠病学
- 外科创新
- 医疗设备技术
背景情况:
- 食道穿孔 (EP) 是一种罕见的,危及生命的疾病,具有显著的发病率和死亡率.
- 在内镜检查过程中造成的阳性损伤是主要的原因,但也存在自发性,创伤性和恶性病因.
- 非特异性症状和EP诊断延迟与患者的治疗结果较差有关.
研究的目的:
- 评估食道穿孔的各种非手术治疗策略的有效性.
- 确定与成功的非手术性 EP 修复相关的关键预测因素.
主要方法:
- 在3个梅奥诊所的72名EP成年患者的回顾性分析 (2007-2023年).
- 根据治疗,患者被分为四组:初级关闭,支架,组合治疗和保守治疗.
- 临床成功 (避免手术) 是主要结局,使用后勤回归来评估.
主要成果:
- 在非手术治疗中,通过初级关闭和组合治疗实现了100%的成功.
- 保守管理的成功率只有42.9%.
- 非保守治疗是成功修复的显著预测因素 (aOR 22. 4, p=0. 036).
结论:
- 主要封闭和组合内镜方法为食道穿孔带来了优异的结果.
- 及时的干预和适当的选择对于避免手术升级和改善EP患者的预后至关重要.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
146
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
146
Esophageal Perforation-I: Introduction
168
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
168
Esophageal Strictures-II: Clinical Features and Management
157
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
157
Esophageal Varices-II: Clinical Features and Management
139
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
139
Barrett Esophagus-II: Clinical Manifestations and Management
293
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
293
Gastroesophageal Reflux Disease II: Clinical Features and Management
199
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
199


