在困难的结直肠病例中,救援混合内镜下粘膜剖析的重要性
Hayato Yamaguchi1, Masakatsu Fukuzawa1, Takashi Kawai2
1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Clinical endoscopy
|July 26, 2023
概括
救援混合内镜下粘膜切割 (ESD) 不是理想的治疗切除由于低的阻塞率. 然而,这种技术对于在困难的结肠直肠病例中避免手术是有用的.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 内視鏡外科手術 內視鏡外科手術
背景情况:
- 混合内镜下粘膜切割 (ESD) 在结直肠手术中具有优势,包括减少手术时间和穿孔风险.
- 救援混合ESD (RH-ESD) 对挑战性结直肠ESD病例的疗效尚未得到充分证实.
研究的目的:
- 在结直肠外科手术中评估救援混合ESD (RH-ESD) 的临床实用性.
主要方法:
- 一项回顾性研究比较了364个结直肠ESD程序.
- 程序被分为传统的ESD (C-ESD,n=260),计划混合的ESD (SH-ESD,n=69) 和RH-ESD (n=35).
- 临床结果包括切除时间和块切除率进行了比较.
主要成果:
- 切割时间最长的是RH-ESD (149分钟),其次是C-ESD (90分钟) 和SH-ESD (52分钟).
- 在C-ESD (97.7%),其次是SH-ESD (78.3%),而在RH-ESD (48.6%) 则最低.
- 在RH-ESD组中,较低的粘膜下切割率与零碎切除有关.
结论:
- RH-ESD 显示了低块切除率,限制了其治疗切除的有效性.
- 尽管在实现治愈切除方面存在局限性,但RH-ESD在防止需要手术干预方面证明是有价值的.
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