多机构内镜切除和复合用于异常性亚结节狭窄症
Diana C Lopez1, Ioan A Lina2, Ryan Stepp3
1Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
The Laryngoscope
|November 27, 2025
概括
内镜切除 (ER) 是一种针对小结节狭窄症 (SGS) 的微创手术. 作为主要治疗方法,ER显示出持久的结果和改善的肺功能,其复发率与公开手术相当.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 最少侵入性的手术
- 呼吸系统医学 呼吸系统医学
背景情况:
- 肠下狭窄症 (SGS) 是一种罕见的气道阻塞.
- 内镜切除 (ER) 或马德登手术是10年前引入的SGS的一种微创手术选择.
- 关于ER的长期耐用性和患者选择的数据有限.
研究的目的:
- 评估ER的耐用性,患者选择标准和异常SGS的并发症率.
- 为了比较ER作为初级最终程序与救助程序的结果.
主要方法:
- 一个多机构的回顾性审查36个ER程序在34名患有异常性SGS的患者 (2016年至今).
- 患者被分为初级确定的 (只有先前的延长) 和救援 (先前的激光,开放手术或ER) 队列.
- 评估的结果包括复发率,气管切除术的需要,最大呼气流量 (PEFR) 和无手术间隔.
主要成果:
- 这项研究包括33名女性和1名男性,平均年龄为49岁.
- 初级最终ER的复发率为21%,救援ER的复发率为71%.
- 成功的ER显著改善了PEFR (预期为55%至97%) 并延长了无手术间隔 (8.4至61.6个月),随访时得到了持续的结果.
结论:
- 最少侵入性ER是一种耐用性SGS治疗的初级治疗方法,其结果与开放式骨切除相似.
- 作为救援程序,ER的复发率更高.
- ER显著改善了SGS患者的呼吸道通透性和生活质量.
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