Perng C L, Lin H J, Lo W C, Lai C R, Guo W S, Lee S D
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Am J Gastroenterol. 1996 May;91(5):987-90.
The aim of this study is to identify factors that will predict which patients with benign gastric outlet obstruction will not respond to endoscopic balloon dilation, in a long-term observation.
Over a 51-month period, 42 patients with benign gastric outlet obstruction received endoscopic balloon dilation. The "through-the-scope" technique with the aid of a guide wire was used for dilation. Fifteen factors were analyzed prospectively in 40 patients. Multivariate analysis was used to find the independent factors of the failure of treatment.
The median follow-up period was 23 months (range 1-51 months). Twenty-eight (67%) patients achieved sustained improvement, and 14 (33%) patients underwent surgery. The overall symptom-free rates in 12, 24, 36, and 48 months were 85.3%, 78%, 68.8%, and 68.8%, respectively. The independent prognostic factor for failure of treatment was the need for more than two courses of endoscopic balloon dilation to relieve symptoms (odds ratio, 6.857; 95% confidence interval, 1,031-45,606).
Endoscopic balloon dilation for the treatment of benign gastric outlet obstructions is an effective alternative to surgery. Patient who needs more than two courses of endoscopic balloon dilation to relieve symptoms should receive surgery.
本研究旨在通过长期观察，确定能够预测哪些良性胃出口梗阻患者对内镜球囊扩张术无反应的因素。
在51个月的时间里，42例良性胃出口梗阻患者接受了内镜球囊扩张术。采用借助导丝的“经内镜”技术进行扩张。对40例患者前瞻性分析了15个因素。采用多变量分析来找出治疗失败的独立因素。
中位随访期为23个月（范围1 - 51个月）。28例（67%）患者病情持续改善，14例（33%）患者接受了手术。12个月、24个月、36个月和48个月时的总体无症状率分别为85.3%、78%、68.8%和68.8%。治疗失败的独立预后因素是需要超过两个疗程的内镜球囊扩张术来缓解症状（比值比，6.857；95%置信区间，1.031 - 45,606）。
内镜球囊扩张术治疗良性胃出口梗阻是一种有效的手术替代方法。需要超过两个疗程的内镜球囊扩张术来缓解症状的患者应接受手术治疗。
