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胃轻瘫患者的经口内镜下幽门肌切开术——是为治愈而冒险还是增加治疗手段?病例系列及文献综述

G-POEM in patients with gastroparesis - gambling for healing or bigger armamentarium ? A case series and review of the literature.

作者信息

Gundling F, Fuchs M, Schepp W, Fox M

机构信息

Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Academic Teaching Hospital Bogenhausen, Technical University of Munich.

Department for Gastroenterology, Gastrointestinal Oncology and Diabetics, Kemperhof Hospital, Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany.

出版信息

Acta Gastroenterol Belg. 2020 Jul-Sep;83(3):475-478.

Abstract

Approximately 30% of all affected patients suffering from gastroparesis do not respond to any available treatment modality. Gastric peroral endoscopic myotomiy (G-POEM, antropyloromyotomy) represents a new principle of therapy. In this single center study, G-POEM showed a high technical success rate with a very low procedural complication rate. However, the clinical response beyond a short-term post-interventional improvement did not succeed in a single patient. The heterogeneity of the clinical picture, which represents a spectrum of different pathophysiological, etiological and clinical characteristics, still requires a therapy tailored to the individual patient. G-POEM should be considered especially in patients with pylorus-dominant gastroparesis.

摘要

所有受胃轻瘫影响的患者中,约30%对任何可用的治疗方式均无反应。经口内镜下胃肌切开术(G-POEM,胃窦肌切开术)代表了一种新的治疗原则。在这项单中心研究中,G-POEM显示出较高的技术成功率和极低的手术并发症发生率。然而,没有一位患者在干预后短期内改善之外还取得了临床反应。临床表现的异质性代表了一系列不同的病理生理、病因和临床特征,仍然需要针对个体患者量身定制治疗方案。G-POEM尤其应考虑用于幽门主导型胃轻瘫患者。

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