对比口腔内镜肌切除术和腹腔镜赫勒肌切除术对于食道运动障碍:全国的队列研究
Yasutoshi Shiratori1,2, Neha Sharma1, Syed Matthew Kodilinye1
1Gastroenterology, Maimonides Medical Center, New York, United States.
Endoscopy international open
|October 27, 2025
概括
口腔内镜肌切除术 (POEM) 在食道运动障碍方面显示出比腹腔镜赫勒肌切除术 (LHM) 更好的结果. 在一项大型美国研究中,POEM导致严重不良事件和重新干预较少.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 相对有效性研究研究比较
背景情况:
- 口腔内镜肌切除术 (POEM) 和腹腔镜赫勒肌切除术 (LHM) 是食道运动障碍的关键治疗方法.
- 以前的比较研究受限于小样本大小,阻碍了概括性.
研究的目的:
- 为了比较POEM与LHM在美国的外科手术期间的结果.
- 评估安全性,有效性和资源利用率,使用大规模的基于人口的数据库.
主要方法:
- 从2016-2022年使用全国住院患者样本 (NIS) 进行回顾性队列研究.
- 包括患有秋症或性食道疾病的患者,接受POEM或LHM.
- 治疗权重的应用反向概率 (IPTW) 治疗可比性.
主要成果:
- 18,694名患者进行了分析 (6,554名POEM,12,140名LHM).
- 与LHM相比,POEM的严重不良事件 (SAE) 和重新干预率明显较低.
- POEM与较短的逗留时间和较低的成本有关;死亡率在各组之间相似.
结论:
- 与LHM相比,POEM在食道运动障碍方面表现出优越的外科治疗结果.
- 尽管LHM更常见,但POEM为患者管理提供了有利的替代方案.
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