胃癌是常见的恶性肿瘤,其诊断主要依靠 X 线钡餐、胃镜及胃液细胞学检查。而早期诊断仍是难题。以往由于胃内气体及粘液的干挠,胃的超声检查被认为是无法进行的;目前应用胃超声快速显像液,很快消除了胃腔内的气体及粘液的干挠,清晰显示...胃癌是常见的恶性肿瘤,其诊断主要依靠 X 线钡餐、胃镜及胃液细胞学检查。而早期诊断仍是难题。以往由于胃内气体及粘液的干挠,胃的超声检查被认为是无法进行的;目前应用胃超声快速显像液,很快消除了胃腔内的气体及粘液的干挠,清晰显示胃壁的厚度、层次。展开更多
Background: Endoluminal gastroplication has shown promise for the treatment of GERD in short-term studies. Until now, long-term outcome data have been lacking. Methods: A prospective, multicenter trial enrolled 85 pat...Background: Endoluminal gastroplication has shown promise for the treatment of GERD in short-term studies. Until now, long-term outcome data have been lacking. Methods: A prospective, multicenter trial enrolled 85 patients with GERD to be treated with endoluminal gastroplication. Inclusion criteria were 3 or more heartburn or regurgitation episodes per week, >4.2%time in 24 hours with esophageal pH < 4, and dependency on antisecretory medications. Exclusion criteria were the presence of varices, achalasia, aperistalsis, or previous gastric resection. Patients underwent manometry, 24-hour pH monitoring, and symptom severity scoring before and after the procedure. Patient diaries were used to assess medication use and to estimate annual medication cost. Results: At 1-and 2-year follow-up, patients had significant reductions in median heartburn symptom scores (72 at baseline [interquartile range (IQR) 90-48] vs. 4 at 12 months [IQR 43-0] and 16 at 24 months [IQR 53-3.5]; p < 0.000 1 vs. baseline) and median regurgitation symptoms (2 at baseline [IQR 3-1] vs. 0 at 12 months (IQR 1-0) and 1 at 24 months [IQR 1-0]; p < 0.000 1 vs. baseline). Of all patients, 59%and 52% showed heartburn symptom resolution at 12 and 24 months, respectively (p < 0.000 1 vs. baseline). Also, 83%and 77%had regurgitation symptom resolution at 12 and 24 months, respectively (p < 0.000 1 vs. baseline). Proton pump inhibitor use also was significantly reduced at 12 and 24 months after the procedure. At 2-year follow-up, median annualized medication costs were reduced by 88%(＄1381) (p < 0.000 1). Endoluminal gastroplication significantly reduced the duration and the number of episodes of esophageal acid exposure (P< 0.000 1 vs. baseline). Only 7 patients experienced adverse events. Conclusions: Endoscopic gastroplication is safe and effective, and is associated with symptom reductions in patients with GERD for at least 24 months.展开更多
文摘Background: Endoluminal gastroplication has shown promise for the treatment of GERD in short-term studies. Until now, long-term outcome data have been lacking. Methods: A prospective, multicenter trial enrolled 85 patients with GERD to be treated with endoluminal gastroplication. Inclusion criteria were 3 or more heartburn or regurgitation episodes per week, >4.2%time in 24 hours with esophageal pH < 4, and dependency on antisecretory medications. Exclusion criteria were the presence of varices, achalasia, aperistalsis, or previous gastric resection. Patients underwent manometry, 24-hour pH monitoring, and symptom severity scoring before and after the procedure. Patient diaries were used to assess medication use and to estimate annual medication cost. Results: At 1-and 2-year follow-up, patients had significant reductions in median heartburn symptom scores (72 at baseline [interquartile range (IQR) 90-48] vs. 4 at 12 months [IQR 43-0] and 16 at 24 months [IQR 53-3.5]; p < 0.000 1 vs. baseline) and median regurgitation symptoms (2 at baseline [IQR 3-1] vs. 0 at 12 months (IQR 1-0) and 1 at 24 months [IQR 1-0]; p < 0.000 1 vs. baseline). Of all patients, 59%and 52% showed heartburn symptom resolution at 12 and 24 months, respectively (p < 0.000 1 vs. baseline). Also, 83%and 77%had regurgitation symptom resolution at 12 and 24 months, respectively (p < 0.000 1 vs. baseline). Proton pump inhibitor use also was significantly reduced at 12 and 24 months after the procedure. At 2-year follow-up, median annualized medication costs were reduced by 88%(＄1381) (p < 0.000 1). Endoluminal gastroplication significantly reduced the duration and the number of episodes of esophageal acid exposure (P< 0.000 1 vs. baseline). Only 7 patients experienced adverse events. Conclusions: Endoscopic gastroplication is safe and effective, and is associated with symptom reductions in patients with GERD for at least 24 months.
