内镜下切开联合丝裂霉素C注射治疗复发性食管良性狭窄的疗效评估

Evaluation of endoscopic incision combined with mitomycin C injection in the treatment of recurrent benign esophageal stenosis

目的评估内镜下切开联合丝裂霉素C注射治疗复发性食管良性狭窄的疗效和安全性。方法对2021年6月—2022年5月在厦门大学附属中山医院消化内科接受内镜下切开联合或不联合丝裂霉素C注射的43例复发性食管良性狭窄患者进行回顾性分析,分为切开组与切开联合丝裂霉素C注射组,对比2组间狭窄缓解率、并发症及预防狭窄复发的效果。结果2组患者均顺利完成治疗,无严重并发症发生。2组患者治疗后狭窄缓解率无显著差异(P>0.05)。随访12个月,切开联合丝裂霉素C注射组在狭窄缓解时长、狭窄复发再次扩张次数及扩张间隔均优于切开组(P<0.05)。结论内镜下切开联合丝裂霉素C注射治疗安全、有效,虽然治疗后狭窄缓解率与单纯切开无显著差异,但可延长狭窄缓解期,改善狭窄复发后重复扩张的频率及间隔时间。

Objective To evaluate the efficacy and safety of endoscopic incision combined with mitomycin C injection in the treatment of recurrent benign esophageal stenosis.Methods A retrospective analysis was conducted on 43 patients with recurrent benign esophageal stenosis who received endoscopic incision combined with or without mitomycin C injection in the Department of Gastroenterology,Zhongshan Hospital of Xiamen University from June 2021 to May 2022.Patients were divided into incision group and incision combined with mitomycin C injection group.The stenosis remission rate,complications and preventive effect of stenosis recurrence were compared between the two groups.Results All patients in the two groups successfully completed the treatment without serious complications.There was no significant difference in the stenosis remission rate between the two groups after treatment(P>0.05).In the follow-up 12 months after treatment,incision combined with mitomycin C injection group was better than incision group in the duration of stenosis remission,the number of stenosis recurrence and dilation interval(P<0.05).Conclusions Endoscopic incision combined with mitomycin C injection is safe and effective.Although the remission rate of stenosis after treatment is not significantly different from that of incision alone,it can prolong the remission period of stenosis and improve the frequency and interval of repeated dilation after stenosis recurrence.