Wen Xu-Peng, Wan Qi-Quan
Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200030, China.
Department of Transplant Surgery, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China.
World J Gastrointest Endosc. 2024 Jan 16;16(1):5-10. doi: 10.4253/wjge.v16.i1.5.
Transoral endoscopic resections in treating upper gastrointestinal submucosal lesions have the advantages of maintaining the integrity of the gastrointestinal lumen, avoiding perforation and reducing gastrointestinal fistulae. They are becoming more widely used in clinical practice, but, they may also present a variety of complications. Gas-related complications are one of the most common, which can be left untreated if the symptoms are mild, but in severe cases, they can lead to rapid changes in the respiratory and circulatory systems in a short period, which can be life-threatening. Therefore, it is important to predict the occurrence of gas-related complications early and take preventive measures actively. Based on the authors' results in the prepublication of the article "Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions," and in conjunction with our evaluation and additions to the relevant content, radiographs may help screen patients at high risk for gas-related complications. Controlling blood glucose levels, shortening the duration of surgery, and choosing the most appropriate surgical resection may positively impact the prognosis of patients at high risk for gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions.
经口内镜切除术治疗上消化道黏膜下病变具有保持胃肠道管腔完整性、避免穿孔和减少胃肠道瘘的优点。它们在临床实践中的应用越来越广泛,但也可能出现各种并发症。气体相关并发症是最常见的并发症之一,如果症状较轻可无需治疗,但在严重情况下,它们可在短时间内导致呼吸和循环系统迅速变化,危及生命。因此,早期预测气体相关并发症的发生并积极采取预防措施很重要。基于作者在文章《预测经口内镜切除上消化道黏膜下病变时气体相关并发症的列线图》预发表中的结果,并结合我们对相关内容的评估和补充,影像学检查可能有助于筛查气体相关并发症的高危患者。控制血糖水平、缩短手术时间以及选择最合适的手术切除方式可能对上消化道黏膜下病变经口内镜切除术中气体相关并发症高危患者的预后产生积极影响。