胃食管反流病创新手术治疗方案的经验:回顾性分析28例患者的结果

IF 1.1 4区 医学 Q3 SURGERY
Moustafa Elshafei
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引用次数: 0

摘要

标准护理胃食管反流病(GERD)手术与不良事件(ae)(即吞咽困难,气胀)相关。reffluxstop的开发就是为了避免这些后果。本研究介绍了德国28例使用RefluxStop治疗的患者的结果。方法:在2021年7月至2023年11月期间,28例GERD患者接受了reffluxstop手术,这是一种新型的腹腔镜抗反流手术。在患者知情同意的情况下进行回顾性图表分析,以确定临床结果,如GERD健康相关生活质量(GERD- hrql)评分、质子泵抑制剂(PPI)使用、症状学、患者满意度和围手术期ae。结果:基线特征(n = 28):年龄47±13.1岁;67.9%的女性;身体质量指数(BMI) 27.3±4.1 kg/m2;93%的患者使用PPI 5.6±2.7年;平均(标准差[SD])尺寸3.4 (0.8)cm的病例100%为裂孔疝,其中大裂孔疝(4-6 cm)占35.7%。在14.1(4.7)个月的平均(SD)随访中,患者的中位(IQR) GERD-HRQL总评分从基线35(7.7)提高到随访时的4(4.2),改善了88.6% (P < 0.05)。术前吞咽困难(35.7%)完全缓解(P < 0.001)。随访时,平均(SD) GERD-HRQL胃灼热亚域从基线18.1(6.1)下降到1.7(1.2),下降了90.6%,所有患者(100%)的评分P < 0.001;只有1例患者需要持续胃反流症状的PPIs。无再次手术或食管扩张病例。7例患者发生轻微术中不良事件(即颈部肺气肿)。结论:RefluxStop治疗胃食管反流具有良好的安全性和有效性。吞咽困难完全缓解(0%),GERD-HRQL中位评分改善88.6%,96.4%的患者达到满意度。这些有希望的结果再现了在现实环境中reffluxstop CE试验中注意到的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experience With an Innovative Surgical Treatment Option for Gastroesophageal Reflux Disease: Results of 28 Patients in a Retrospective Analysis.

Introduction: Standard-of-care gastroesophageal reflux disease (GERD) procedures are associated with adverse events (AEs) (i.e., dysphagia, gas-bloating). RefluxStop has been developed to circumvent these outcomes. This study presents the results of 28 patients managed with RefluxStop in Germany. Methods: Between July 2021 and November 2023, 28 patients with GERD underwent RefluxStop surgery, a novel laparoscopic antireflux procedure. Retrospective chart analysis with patient-informed consent was conducted to determine clinical outcomes, such as GERD Health-Related Quality of Life (GERD-HRQL) score, proton pump inhibitors (PPI) use, symptomatology, patient satisfaction, and perioperative AEs. Results: Baseline characteristics (n = 28): age 47 ± 13.1 years; 67.9% female; body mass index (BMI) 27.3 ± 4.1 kg/m2; 93% PPI use for 5.6 ± 2.7 years; and hiatal hernia in 100% of cases of mean (standard deviation [SD]) size 3.4 (0.8) cm, whereof 35.7% were large hiatal hernia (4-6 cm). At a mean (SD) follow-up of 14.1 (4.7) months, patients experienced 88.6% improvement in median (IQR) total GERD-HRQL score from a baseline of 35 (7.7) to 4 (4.2) at follow-up (P < .05). Preoperative dysphagia (35.7%) resolved completely in all patients (P < .001). The mean (SD) GERD-HRQL heartburn subdomain decreased by 90.6% from a baseline of 18.1 (6.1) to 1.7 (1.2) at follow-up and all patients (100%) had scores <5. Similarly, the mean (SD) regurgitation subdomain decreased from a baseline of 13.2 (4.7) to 2 (1.6) at follow-up and all patients (100%) had scores <5. Patient satisfaction was achieved in 96.4% of patients with no PPI use required in 93% of patients (P < .001); only one patient required PPIs for persistent GERD symptoms. No cases of reoperation or esophageal dilatation were performed. Minor intraoperative AEs occurred in seven patients (i.e., neck emphysema). Conclusion: RefluxStop provides excellent safety and effectiveness outcomes for GERD treatment. Dysphagia completely resolved (0%) with 88.6% improvement in median GERD-HRQL score and satisfaction achieved in 96.4% of patients. These promising results reproduced the outcomes noted in the RefluxStop CE trial in real-world settings.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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