内镜治疗与手术治疗GERD:一个系统的审查和网络元分析
Ravi Teja Pasam1, Karim T Osman2, Babu P Mohan3
1Department of Medicine, Wentworth-Douglass Hospital, Dover, New Hampshire, USA.
iGIE : innovation, investigation and insights
|February 6, 2026
概括
穿越口腔无切口膜 (TIF) 和射频能量 (RFe) 传递显示了与手术选择相比的GERD-HRQL得分,但RFe对LESP来说较差. 对于非外科候选人来说,TIF可能是一个替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 医疗技术评估 医疗技术评估
背景情况:
- 胃食道逆流性疾病 (GERD) 显著影响生活质量.
- 内镜和手术疗法为GERD提供了各种治疗选择.
- 这些干预措施的比较有效性数据对于临床决策至关重要.
研究的目的:
- 进行一个网络元分析,比较内镜治疗和手术治疗GERD.
- 评估包括GERD-HRQL,PPI使用,食道炎,pH监测和LESP在内的结果.
- 提供基于证据的见解,了解不同GERD治疗的疗效.
主要方法:
- 成年GERD患者随机对照试验的网络元分析.
- 包括的干预措施:射频能量 (RFe) 传递,横口无切口基底复合 (TIF),磁性关节增大 (MSA),以及尼森,图佩特和前侧基底复合.
- 主要结局:GERD-HRQL,PPI使用,食道炎,%时间pH<4,LESP在≤12个月.
主要成果:
- 分析了27项涉及3515名患者的研究.
- 与彼此相比,TIF和RFe在GERD-HRQL中没有显著差异,但比单独的PPI更好.
- 对于食道炎,pH值监测或PPI停止的内镜和手术程序之间没有显著差异.
- 在LESP方面,RFe低于TIF和所有外科基底部应用;LESP在内镜和外科基底部应用之间是可比的.
结论:
- 穿越口腔无切口基底切片 (TIF) 显示了与手术基底切片相比的短期结果.
- 对于那些不愿意或无法接受手术的患者,可以考虑TIF.
- 射频能量 (RFe) 比TIF和外科选择效率低,特别是对于LESP.
- 磁性缩器增大 (MSA) 需要通过更多随机对照试验进行进一步的调查.
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