气囊扩张术或腹腔镜贲门肌切开术治疗新诊断的特发性贲门失弛缓症：一项随机对照试验的结果
Pneumatic dilatation or laparoscopic cardiomyotomy in the management of newly diagnosed idiopathic achalasia. Results of a randomized controlled trial.
作者信息
Kostic S, Kjellin A, Ruth M, Lönroth H, Johnsson E, Andersson M, Lundell L
机构信息
Department of General Surgery, Borås Central Hospital, Brämhultsvägen 53, S-501 82, Borås, Sweden.
出版信息
World J Surg. 2007 Mar;31(3):470-8. doi: 10.1007/s00268-006-0600-9.
BACKGROUND
The most effective therapeutic strategy in newly diagnosed achalasia is yet to be established. Therefore we designed a study in which pneumatic dilatation was compared to laparoscopic cardiomyotomy to which was added a partial posterior fundoplication.
PATIENTS AND RESULTS
A series of 51 patients (24 males, mean age 44 years) were randomly allocated to the therapeutic modalities (dilatation = 26, surgery = 25). All patients were followed for at least 12 months, and during that period the pneumatic dilatations strategy had significantly more treatment failures (P = 0.04). Only minor differences emerged between the study groups when symptoms, dysphagia scorings, and quality-of-life assessments were evaluated 12 months after initiation of therapy.
CONCLUSIONS
Laparoscopic myotomy was found to be superior to an endoscopic balloon dilatation strategy in the treatment of achalasia when studied during the first 12 months after treatment.
背景
新诊断的贲门失弛缓症最有效的治疗策略尚未确立。因此，我们设计了一项研究，将气囊扩张术与腹腔镜贲门肌切开术加部分胃底后壁折叠术进行比较。
患者与结果
51例患者（24例男性，平均年龄44岁）被随机分配至不同治疗方式组（扩张术组 = 26例，手术组 = 25例）。所有患者均随访至少12个月，在此期间，气囊扩张术策略的治疗失败率显著更高（P = 0.04）。在治疗开始12个月后评估症状、吞咽困难评分和生活质量评估时，研究组之间仅出现微小差异。
结论
在治疗后的前12个月进行研究时，发现腹腔镜肌切开术在贲门失弛缓症的治疗中优于内镜球囊扩张术策略。
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