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首页> 外文期刊>Digestive Diseases and Sciences >Schatzki's Ring: To Cut or Break an Unresolved Problem
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Schatzki's Ring: To Cut or Break an Unresolved Problem

机译：沙茨基之戒：削减或打破未解决的问题

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Symptom assessment has been proven to be less reliable than barium pill testing for success of dilation of peptic strictures. Schatzki's ring also has a high recurrence rate. Our aim here was to compare the efficacy of single dilatation with a 54-F Savary dilator and electrosurgical ring incision for symptomatic Schatzki's rings. Schatzki's ring patients who failed to pass a 12.7-mm barium pill were randomized to dilatation with a 54-F Savary dilator or four quadrant incisions with a needle knife. All received lansoprazole (30 mg) for 30 days posttreatment. Follow-up at 1, 3, 6, and 12 months used the pill test and a dysphagia score. Eleven patients (mean age, 62; median, 64) were randomized and received therapy, six with dilatation and five with incision. The ring diameter pretherapy was 9.8 ± 1.3 mm. One patient with dilatation had a procedure-related esophageal perforation. The dysphagia score decreased (from 2.7 ± 1.1 predilatation and 3.0 ± 0.4 preincision) to 0 after treatment, suggesting that both therapies were equally successful. In contrast, using objective measurements with the barium pill showed that the pill failed to pass the ring in 60% at 1 month after therapy. The failure rate by 1 year was 100%. Use of an objective measure of effectiveness of treatment of symptomatic Schatzki's rings showed that neither single large-dilator dilatation nor four quadrant ring incision was a reliable and effective therapy. In the future studies, repeated dilatation may be needed to define success before long-term outcome can be accurately assessed.
机译：事实证明，对于消化道狭窄的成功扩张，症状评估的可靠性不如钡药测试。沙茨基戒指的复发率也很高。我们的目的是比较有症状的Schatzki环的54-F Savary扩张器和电外科环切开术的单次扩张效果。未通过12.7毫米钡丸的Schatzki环形患者被随机分配用54-F Savary扩张器或用针刀切开四个象限的切口进行扩张。所有患者均在治疗后30天内接受了lansoprazole（30 mg）。在1、3、6和12个月的随访中使用药丸测试和吞咽困难评分。随机分配11例患者（平均年龄62岁；中位64位），接受治疗，其中6例行扩张术，5例行切口治疗。治疗前的环直径为9.8±1.3毫米。一名扩张患者进行了与手术相关的食管穿孔。吞咽困难评分从治疗前的2.7±1.1扩张和切口前的3.0±0.4降低到0，表明两种疗法同样成功。相比之下，对钡丸进行客观测量表明，该丸在治疗后1个月内未能通过60％的环。一年的失败率是100％。对症状性Schatzki环的疗效进行客观测量的结果表明，单次大扩张器扩张或四象限环切开术都不是可靠且有效的治疗方法。在未来的研究中，可能需要反复进行扩张以定义成功，然后才能准确评估长期结果。

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