METHODS: Since 2022, eight consecutive patients with VP and affected by PES were treated with BTX-A injection by a standard videofluoroscopic guided technique at the European Institute of Oncology, IRCCS (IEO) in Milan. A lidocaine test was performed pre-operatively to evaluate the potential effect of chemical neurectomy. All patients with positive lidocaine tests were injected with 50 IU of BTX-A (Allergan, Irvine, CA) according to the sites marked during the videofluoroscopy. Reported symptoms (VHI, SECEL), perceptual (INFVo), aerodynamic (MPT) and manometric parameters were collected before and after treatment.
RESULTS: In all cases, BTX-A was performed as an outpatient procedure without complications. For seven patients, only one BTX-A injection was needed, while one patient required a re-injection. Subjective and perceptive improvement after BTX-A was significant for VHI, SECEL and INFVo. MPT showed significant improvement after a chemical neurectomy. After a mean follow-up of 6 months, all patients maintained a good TES quality.
CONCLUSIONS: The videofluoroscopic guided BTX-A injection of the pharyngoesophageal tract showed to be a feasible and reproducible technique in all cases. The pharyngoesophageal videofluoroscopy allows defining of patients\' anatomical landmarks that help the surgeon to perform a homogeneous injection, empowered by post-injection massage.
方法:自2022年以来,在欧洲肿瘤学研究所,通过标准的视频透视引导技术,对八名连续患有VP并受PES影响的患者进行了BTX-A注射治疗。IRCCS(IEO)在米兰。术前进行利多卡因试验以评估化学神经切除术的潜在效果。所有利多卡因试验阳性的患者均注射50IU的BTX-A(Allergan,Irvine,CA)根据视频透视检查期间标记的部位。报告的症状(VHI,SECEL),感知(INFVo),收集治疗前后的空气动力学(MPT)和测压参数。
结果:在所有情况下,BTX-A作为门诊手术进行,没有并发症。对于七个病人来说,只需要注射一次BTX-A,而一名患者需要重新注射。BTX-A后主观和感知的改善对VHI显著,SECEL和INFVo。化学神经切除术后MPT显着改善。经过6个月的平均随访,所有患者均保持良好的TES质量。
结论:视频透视引导下BTX-A在所有病例中都是可行且可重复的技术。咽食管透视检查允许定义患者的解剖标志,帮助外科医生进行均匀注射,注射后按摩。