GIE: 射频消融可明显降低巴雷特食管低度不典型增生的进一步发展

2020-10-04 MedSci原创 MedSci原创

巴雷特食管炎(BE)是食管腺癌的癌前病变,这种疾病的发病率不断上升。

        巴雷特食管炎(BE)是食管腺癌的癌前病变,这种疾病的发病率不断上升,患者会逐步从非增生性肠上皮化生(IM)发展至低度不典型增生(LGD),高度不典型增生(HGD)以及最终浸润性癌症。当前的国际指南建议内镜治疗伴有HGD或早期的BE需行内镜切除术(ER)或射频消融术(RFA)。本项研究的目的是探究射频消融术(RFA)对于降低巴雷特食管炎

 

        研究人员将确诊LGD的BE患者随机分配至RFA或监测保守治疗组。主要观察结局是BE患者进展为高度不典型增生(HGD)/癌症的速度。纳入本项研究中随机分配至RFA(n = 68)或监测(n = 68)组的共有136例患者。研究结束后,根据患者的喜好和研究结果,对15名监测患者进行了RFA癌变的风险的分析。

 

        研究结果显示:从随机分组到最后一次内镜检查的中位随访时间为73个月。在RFA组中有1名患者(1.5%)最后被诊断出HGD /癌症,在监测组中有23名(33.8%)被诊断出HGD /癌症( P = .0001),因此绝对风险降低了32.4%(95%置信区间[CI] ],22.4%-44.2%)。用RFA治疗BE的83例患者中有75例(90%; 95%CI,82.1%-95.0%)达到了BE的完全清除和不典型增生。75例患者中有7例(9%; 95%CI,4.6%-18.0%)复发。

 

        经本项研究证实,患有LGD的BE患者行RFA后显着降低了恶性进展的风险。

 

 

原始出处:

Roos E. Pouw. Et al. Radiofrequency ablation for low-grade dysplasia in Barrett’s esophagus: long-term outcome of a randomized trial. Gastrointestinal Endoscopy.2020.

 

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    2021-11-25 ms3000001096233086

    学习了

    0

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    2020-10-07 yaanren
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    2020-10-06 zhouqu_8

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为了更有效的隔离肺静脉(PVI)和尽量降低房颤(AF)消融术后心律失常的复发率,现已开发出了新一代的消融技术。为对比各种消融技术的有效性和安全性,研究人员开展一多中心的随机化单盲试验,将346位药物难治性阵发性AF患者随机分至三组:接触力引导射频消融组(CF-RF,115人)、4分钟冷冻球囊消融组(Cryo-4,115人)和2分钟冷冻球囊消融组(Cryo-2,116人)。随访12个月。主要预后是在

原创Liwen RF(TM)射频消融及心肌活检系统带来肥心病诊治创新策略

空军军医大学西京医院肥厚型心肌病诊治中心刘丽文主任团队,联合诺诚医疗共同研发的Liwen RF™射频消融系统(以下简称Liwen RF™系统),在西京医院相继完成15台临床应用,手术过程顺利,患者恢复良好,这是“Liwen术式”在治疗肥厚型心肌病领域,首次融入2项全球首创的新技术 -- 可调射频消融针和心肌活检。“Liwen术式”+可调射频消融针 空军军医大学西京医院肥厚型心肌病诊治中心刘丽文主任

子宫内膜射频消融术后自然妊娠并足月活产1例

患者,女,34岁。因自然流产后10个月,阴道 不规则出血2个月于2013年8月27日入院。平素 月经欠规律,7/30~32 d,量多,曾因大出血、重度贫 血行诊刮术,病理提示子宫内膜息肉(具体不详)。 lo个月前于孕5个月自然流产,诉胎盘未排出,行 钳夹术。其后月经经期延长至10~15 d,周期无改 变,经量为原来2倍,LMP:2013一06—28,此次量少但 淋漓不尽,持续2个月。

内镜下ESD及射频消融治疗食管及结肠病变

内镜下ESD及射频消融治疗食管及结肠病变

Thyroid:甲状腺良性结节射频和激光消融的五年结局

两种热消融技术均能使良性甲状腺结节患者获得临床上显著且持久的体积减少。RFA后,再生和需要再次治疗的风险较低。再次治疗与年龄小、基线体积大和能量输送低的治疗有关。