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治疗贲门失弛缓症后胃食管反流病的管理:权衡风险和获益。

Navigating reflux disease after achalasia treatments: Balancing risks and benefits.

机构信息

Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, West Midlands, United Kingdom.

Department of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, West Midlands, United Kingdom.

出版信息

World J Gastroenterol. 2024 Jun 7;30(21):2740-2743. doi: 10.3748/wjg.v30.i21.2740.

Abstract

The peroral endoscopic myotomy (POEM) procedure has revolutionized the management of achalasia in many centres around the world as it offers patients a minimally invasive endoscopic solution to their dysphagia caused by achalasia. Alongside its success in alleviating dysphagia, concerns regarding postoperative gastroesophageal reflux disease have emerged as a pertinent issue which are not fully resolved. In this study, Nabi have comprehensively reviewed the topic of the prediction, prevention and management of gastroesophageal reflux after POEM. POEM is a purely endoscopic procedure which is usually performed without any anti-reflux procedure. Certain patients may be better served by a laparoscopic Heller's myotomy and fundoplication and it is important that gastroenterologists and surgeons provide comprehensive risks and benefits of each achalasia treatment option so that patients can decide what treatment is best for them. This article by Nabi provides a comprehensive review of the current status of this issue to allow these discussions to occur.

摘要

经口内镜下肌切开术(POEM)在世界范围内的许多中心改变了贲门失弛缓症的治疗方式,因为它为因贲门失弛缓症导致吞咽困难的患者提供了一种微创的内镜解决方案。除了成功缓解吞咽困难外,术后胃食管反流病的问题也引起了关注,这是一个尚未完全解决的问题。在这项研究中,Nabi 全面回顾了 POEM 术后胃食管反流的预测、预防和管理这一主题。POEM 是一种纯粹的内镜手术,通常无需任何抗反流手术。某些患者可能更适合腹腔镜 Heller 肌切开术和胃底折叠术,重要的是,胃肠病学家和外科医生应全面告知每种贲门失弛缓症治疗方案的风险和获益,以便患者可以决定哪种治疗方案最适合他们。Nabi 的这篇文章全面回顾了这一问题的现状,以促进相关讨论。

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