The Efficacy and Safety of Endoscopic Submucosal Dissection (ESD) Combined With Radiofrequency Ablation (RFA) Sequential Therapy for Extensive Esophageal Lesions.

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yuan Ding, Lu Chen, Xiaochun Yin, Qin Lu, Zhi Wang, Yinnan Zhu, Ruihua Shi
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引用次数: 0

Abstract

Purpose: This study aimed to evaluate the efficacy and safety of a sequential treatment combining endoscopic submucosal dissection (ESD) with radiofrequency ablation (RFA) for extensive esophageal lesions, focusing on reducing esophageal stenosis and improving patients' quality of life.

Methods: We conducted a retrospective analysis of patients with extensive esophageal lesions who underwent sequential treatment of ESD and RFA. Lesion characteristics were assessed using Lugol's iodine staining, white-light endoscopy, and ultrasound endoscopy. The non-stained area was treated with ESD, and the remaining lightly stained area was subsequently treated with RFA.

Results: A total of 80 patients were enrolled in the study. The sequential therapy significantly reduced the incidence of esophageal stenosis compared to ESD monotherapy. The postoperative adverse events were lower in the sequential therapy group. There was no significant difference in postoperative recurrence rate between the two groups.

Conclusion: Sequential ESD-RFA therapy significantly reduces stricture rates (30% vs. 60%, p = 0.02) and improves 12-month quality of life (SF-36: 82.55 vs. 74.40, p = 0.001) compared to ESD monotherapy, while maintaining equivalent complete remission rates (100% vs. 96.7%, p = 0.16). This approach is particularly advantageous for lesions > 10 cm or involving > 3/4 circumference.

内镜下粘膜剥离联合射频消融序贯治疗广泛食管病变的疗效和安全性。
目的:本研究旨在评价内镜下粘膜剥离(ESD)联合射频消融(RFA)序贯治疗广泛食管病变的疗效和安全性,重点是减少食管狭窄,提高患者的生活质量。方法:我们对接受ESD和RFA序贯治疗的广泛食管病变患者进行回顾性分析。采用Lugol's碘染色、白光内镜和超声内镜评估病变特征。未染色区域用ESD处理,剩余轻度染色区域随后用RFA处理。结果:共有80例患者入组研究。与单药治疗相比,序贯治疗显著降低了食管狭窄的发生率。顺序治疗组术后不良事件发生率较低。两组术后复发率差异无统计学意义。结论:与单一ESD治疗相比,序贯ESD- rfa治疗可显著降低狭窄率(30%对60%,p = 0.02),改善12个月生活质量(SF-36: 82.55对74.40,p = 0.001),同时保持相同的完全缓解率(100%对96.7%,p = 0.16)。这种方法对bb10 cm或bb3 /4周长的病变特别有利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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