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肉毒杆菌毒素预防食管切除术后胃排空延迟

Botulinum toxin for prevention of delayed gastric emptying after esophagectomy.

作者信息

Bagheri Reza, Fattahi Seyed Hossein, Haghi Seyed Ziaollah, Aryana Kamran, Aryanniya Ali, Akhlaghi Saeed, Riyabi Fateme Naghavi, Sheibani Shima

机构信息

Cardiothoracic Surgery and Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Asian Cardiovasc Thorac Ann. 2013 Dec;21(6):689-92. doi: 10.1177/0218492312468438. Epub 2013 Jul 11.

DOI:10.1177/0218492312468438
PMID:24569327
Abstract

BACKGROUND

Esophageal cancer is among the most common gastrointestinal cancers for which the main treatment is surgery. This study was undertaken to analyze the results of Botox injection in preventing gastric stasis in these patients.

PATIENTS AND METHODS

60 patients with esophageal cancer in the middle and lower third parts were included in our study between 2010 and 2011, and were randomly divided into two groups. In group A, 30 patients underwent pyloroplasty, and in group B, injection of botulinum toxin into the pyloric sphincter muscle was used in 30 patients.

RESULTS

The mean age of these patients was 61 ± 10.7 years and the male/female ratio was 33:27. Isotope scans 3 weeks after surgery showed that 5 patients in group A and 3 in group B had delayed gastric emptying; there was no significant difference between the 2 groups, and the success rate of Botox injection was 90%.

CONCLUSION

Considering the fact that there was no significant difference between pyloroplasty and Botox injection on gastric emptying after surgery, and given the need to use less-aggressive techniques and facilitate greater use of endoscopic methods, botulinum toxin injection may be used instead of pyloroplasty as a simple, effective, and complication-free method to prevent delayed gastric emptying.

摘要

背景

食管癌是最常见的胃肠道癌症之一,其主要治疗方法是手术。本研究旨在分析肉毒杆菌毒素注射预防这些患者胃潴留的效果。

患者与方法

2010年至2011年期间,我们纳入了60例食管中下段癌患者,并将其随机分为两组。A组30例患者接受了幽门成形术,B组30例患者采用向幽门括约肌注射肉毒杆菌毒素的方法。

结果

这些患者的平均年龄为61±10.7岁,男女比例为33:27。术后3周的同位素扫描显示,A组有5例患者、B组有3例患者出现胃排空延迟;两组之间无显著差异,肉毒杆菌毒素注射的成功率为90%。

结论

鉴于幽门成形术和肉毒杆菌毒素注射在术后胃排空方面无显著差异,且考虑到需要采用侵入性较小的技术并促进内镜方法的更多应用,肉毒杆菌毒素注射可作为一种简单、有效且无并发症的方法,替代幽门成形术来预防胃排空延迟。

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