全喉切除术后食道收紧状态的危险因素:系统性审查和元分析
Jordan Stellern1,2, Michaele Francesco Corbisiero3,4, Gregory Burnet4
1Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, USA. Jordan.stellern@med.usc.edu.
Dysphagia
|March 4, 2026
概括
在全喉切除术后食道狭窄是常见的. 之前的辐射,喉切除术,晚期瘤和烟草使用增加了风险,为头癌患者提供了预防策略.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 食道狭窄是全喉切除术后的严重并发症,影响生活质量.
- 高复发率需要识别风险因素,以改善管理.
研究的目的:
- 系统地审查和对全喉切除术后食道狭窄形成的风险因素进行元分析.
- 为头癌患者提供预防策略和指导多学科决策.
主要方法:
- 按照PRISMA指导方针进行系统审查,并通过Embase,MEDLINE和Web of Science进行搜索.
- 一个样本的元分析使用随机效应模型与元回归来评估共变量.
- 包括48项研究,包括4,919次全喉切除术和996次收缩术.
主要成果:
- 在全喉切除术后,食道整体收缩率为20.25%.
- 较高的狭窄率与先前的辐射治疗 (23%),喉切除术 (26%),下喉瘤,晚期结节疾病 (N2/N3) 和机械关闭 (p <0.01) 相关.
- 烟草/尼古丁的使用显示,与缩率的增加有着适度的关联 (19%).
结论:
- 确定了与喉切除术后食道狭窄相关的临床病理和技术因素.
- 观察到实质性的研究间异质性,而元回归解释了一些变化.
- 结果可能会指导风险咨询和手术技术选择,但需要进行前性研究.
相关概念视频
Esophageal Strictures-I: Introduction
1.0K
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
1.0K
Esophageal Strictures-II: Clinical Features and Management
801
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...
801
Barrett Esophagus-I: Introduction
1.1K
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
1.1K
Barrett Esophagus-II: Clinical Manifestations and Management
1.3K
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...
1.3K
Esophageal Perforation-I: Introduction
687
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....
687
Esophageal Varices-I: Introduction
1.8K
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
1.8K


