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药物涂层球囊扩张治疗良性食管狭窄的临床疗效

Clinical outcomes of drug-coated balloons dilatation for benign esophageal stricture.

作者信息

Ren Kewei, Bi Yonghua, Ren Jianzhuang, Han Xinwei

机构信息

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jian She Road, Zhengzhou, 450052, China.

出版信息

BMC Gastroenterol. 2024 Oct 1;24(1):340. doi: 10.1186/s12876-024-03441-2.

Abstract

BACKGROUND

Drug-coated balloons (DCBs) angioplasty is safe and effective for coronary artery disease. However, DCBs dilatation for the treatment of benign esophageal strictures is rarely reported.

PURPOSE

We aimed to report the clinical outcomes of DCBs dilatation for patients with benign esophageal strictures.

METHODS

From May 2020 to August 2023, 18 patients underwent DCBs dilatation for benign esophageal strictures. Baseline demographics were recorded and evaluated, including gender, age, comorbidities, stricture diameter and length, dilatation session, complications.

RESULTS

A total of 24 dilatation sessions of DCBs were performed, with a mean of 1.3 ± 0.6 sessions per patients (range 1.0-5.0). Dysphagia score decreased significantly after DCBs dilatation (2.6 ± 1.1 vs. 0.9 ± 1.3, p = 0.0002). Both stricture diameter and stricture index decreased significantly after DCBs dilatation (p < 0.0001). No procedure-related death, massive bleeding or esophageal perforation was observed during or after DCBs dilatation. Minor complications were found in only 3 patients (16.7%). All 18 patients were successfully followed up for a median period of 12.0 months. By the end of follow up, 10 patients showed no dysphagia, 6 patients showed mild dysphagia and 2 patients showed no improvement in dysphagia. The clinical success rate of DCBs dilatation is 88.9%.

CONCLUSION

DCBs dilatation may be a safe, effective and feasible treatment for benign esophageal strictures, and can be utilized as an alternative option after standard dilatation has failed. Prospective studies with large samples are needed to further validate its clinical efficacy.

摘要

背景

药物涂层球囊(DCB)血管成形术治疗冠状动脉疾病安全有效。然而,DCB扩张术治疗良性食管狭窄的报道很少。

目的

我们旨在报告DCB扩张术治疗良性食管狭窄患者的临床结果。

方法

2020年5月至2023年8月,18例患者接受DCB扩张术治疗良性食管狭窄。记录并评估基线人口统计学数据,包括性别、年龄、合并症、狭窄直径和长度、扩张次数、并发症。

结果

共进行了24次DCB扩张术,每位患者平均1.3±0.6次(范围1.0 - 5.0次)。DCB扩张术后吞咽困难评分显著降低(2.6±1.1对0.9±1.3,p = 0.0002)。DCB扩张术后狭窄直径和狭窄指数均显著降低(p < 0.0001)。DCB扩张术期间及术后未观察到与手术相关的死亡、大出血或食管穿孔。仅3例患者(16.7%)出现轻微并发症。18例患者均成功随访,中位随访期为12.0个月。随访结束时,10例患者无吞咽困难,6例患者有轻度吞咽困难,2例患者吞咽困难无改善。DCB扩张术的临床成功率为88.9%。

结论

DCB扩张术可能是治疗良性食管狭窄的一种安全、有效且可行的方法,可作为标准扩张术失败后的替代选择。需要进行大样本前瞻性研究以进一步验证其临床疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/714d/11443842/2eff9d337885/12876_2024_3441_Fig1_HTML.jpg

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