老年患者的食管内镜黏膜下剥离术是安全可行的：美国一项回顾性单中心队列研究
Esophageal Endoscopic Submucosal Dissection in Older Patients Is Safe and Feasible: A Retrospective Single-Center Cohort Study in the United States.
作者信息
Koseki Mako, Nishimura Makoto, Beauvais Jacques C, Nammour Tarek, Nagao Sayaka, Schattner Mark A
机构信息
Gastroenterology, Hepatology, and Nutrition Service, Memorial Slone Kettering Cancer Center, New York, NY 10065, USA.
Internal Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA.
出版信息
J Clin Med. 2023 Dec 30;13(1):228. doi: 10.3390/jcm13010228.
BACKGROUND
Endoscopic submucosal dissection (ESD) is a well-established method for treating early esophageal carcinomas. However, data on the safety and efficacy of esophageal ESD in older patients in the United States are limited.
METHODS
This retrospective study investigated the outcomes of esophageal ESD in patients aged ≥80 years and included those who underwent esophageal ESD between June 2018 and April 2023 at a single center in the United States. Patients were divided into two age groups for comparison: ≥80 and <80 years. Treatment outcomes and complications were evaluated and compared between these groups.
RESULTS
A total of 53 cases of esophageal ESD for malignant neoplasms were included, with 12 patients in the ≥80 years age group. No significant differences were observed in the patients' background and characteristics, except for a prior history of interventions ( = 0.04). The en bloc resection rate was 100% in both groups. The R0 resection rate was lower in the ≥80 years age group (75% vs. 88%). There were no complications requiring additional intervention in the ≥80 years age group, such as post-ESD bleeding, perforation, mediastinal emphysema, or pneumonia.
CONCLUSIONS
Esophageal ESD may be a safe and feasible procedure for treating esophageal carcinomas in older patients.
背景
内镜黏膜下剥离术（ESD）是治疗早期食管癌的一种成熟方法。然而，在美国老年患者中，食管ESD安全性和有效性的数据有限。
方法
这项回顾性研究调查了年龄≥80岁患者的食管ESD治疗结果，纳入了2018年6月至2023年4月在美国一家单一中心接受食管ESD治疗的患者。将患者分为两个年龄组进行比较：≥80岁和<80岁。评估并比较了这些组之间的治疗结果和并发症。
结果
共纳入53例因恶性肿瘤接受食管ESD治疗的病例，其中≥80岁年龄组有12例患者。除既往干预史外（P = 0.04），患者的背景和特征未观察到显著差异。两组的整块切除率均为100%。≥80岁年龄组的R0切除率较低（75%对88%）。≥80岁年龄组没有发生需要额外干预的并发症，如ESD术后出血、穿孔、纵隔气肿或肺炎。
结论
食管ESD对于老年患者治疗食管癌可能是一种安全可行的手术。
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