一项回顾性多中心队列研究:胃近端切除双道重建后内镜检查成功率及相关因素。

IF 3.8 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Ji Won Seo, Ki Bum Park
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引用次数: 0

摘要

目的:本研究旨在分析近端胃切除术(PG)双胃道重建术(DTR)后残余胃的充分观察率。材料和方法:纳入韩国6家机构的胃癌PG合并DTR患者的数据。回顾性分析临床病理和一系列内镜资料。成功的内窥镜检查被定义为幽门腔的摄影记录。采用混合效应logistic回归模型分析内镜检查成功的相关因素。结果:160例PG合并DTR患者共进行634次监测内镜检查。从手术到内镜检查的中位时间为17.5个月(范围0-137个月)。内镜检查总成功率为75.6%。内镜检查成功的平均总手术时间为439.4±336.0秒,检查失败的平均总手术时间为373.7±326.0秒(P=0.033)。尽管31.9%的患者在第一次内镜检查中失败,但除了3名患者外,所有患者在第四次内镜检查中至少成功进行了一次。内镜检查成功的相关因素包括手术时间较长(优势比[OR], 1.32;95%可信区间[CI], 1.01-1.72),由没有PG经验的内窥镜医师进行内窥镜检查(OR, 0.19;95% CI, 0.11-0.36),术后持续时间较长(OR, 1.33;95% ci, 1.02-1.72)。结论:了解PG合并DTR后的解剖变化是成功监测内窥镜检查的关键。此外,所有系列内窥镜检查的失败率非常低。因此,无论之前的检查结果如何,临床医生都应确保内镜检查过程中有足够的操作时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Success Rate and Factors Associated With Surveillance Endoscopy After Proximal Gastrectomy With Double-Tract Reconstruction: A Retrospective Multicenter Cohort Study.

Purpose: This study aimed to analyze the rate of adequate observation of the remnant stomach after proximal gastrectomy (PG) with double-tract reconstruction (DTR).

Materials and methods: Data from patients who underwent PG with DTR for gastric cancer at 6 institutions in South Korea were included. The clinicopathological and serial endoscopic data were retrospectively analyzed. Successful surveillance endoscopy was defined as photographic documentation of the pyloric antrum. Factors associated with successful endoscopy were analyzed using a mixed-effects logistic regression model.

Results: In total, 634 surveillance endoscopies were performed in 160 patients after they underwent PG with DTR. The median time from surgery to endoscopy was 17.5 months (range, 0-137 months). The overall success rate of endoscopy was 75.6%. The mean total procedure time for successful endoscopies was 439.4±336.0 seconds, compared with 373.7±326.0 seconds for failed examinations (P=0.033). Although 31.9% of the patients experienced failure during their first endoscopy, all but 3 patients achieved at least one successful endoscopy by the fourth session. Factors associated with successful endoscopy included longer procedure time (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.01-1.72), endoscopy performed by an endoscopist without prior PG experience (OR, 0.19; 95% CI, 0.11-0.36), and a longer duration after surgery (OR, 1.33; 95% CI, 1.02-1.72).

Conclusions: Understanding the anatomical changes after PG with DTR is essential for successful surveillance endoscopy. In addition, the failure rates across all serial endoscopies are very low. Therefore, clinicians should ensure sufficient procedure time during endoscopy, regardless of the outcomes of previous examinations.

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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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