大型静脉动聚体的内镜切除是安全有效的
Oliver Cronin1,2, Sunil Gupta1,2, Julia Gauci1,2
1Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia.
Endoscopy
|September 12, 2023
概括
大型腺瘤性解剖性聚合体 (LAAP) 很少见,但可以通过内镜安全有效地切除. 这项研究表明,内镜切除后没有复发,证明了可行的治疗策略.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 结肠直肠手术 结肠直肠手术
背景情况:
- 大型腺瘤解剖性聚合体 (LAAP) 不常见,关于其患病率和内镜切除 (ER) 疗效的数据有限.
- 为LAAP制定安全有效的ER策略,可以减少患者的发病率和医疗保健费用.
研究的目的:
- 调查大腺瘤性解剖性聚合体 (LAAPs) 的内镜切除的患病率,特征和结果.
- 对LAAP进行内镜切除技术的安全性和有效性进行评估.
主要方法:
- 对长达7年内内镜切除 (ER) 所指的大型非踏脚结直肠多体 (LNPCPs) ≥20mm进行前性研究.
- 数据收集包括多的位置 (解剖学与常规),形态,切除方法,并发症和技术成功.
- 关于切除技术和结果的LAAP和传统LNPCP组之间的比较.
主要成果:
- 在2629个引用的病变中,发现了10个 (0.4%) 的LAAP (中位数为35mm).
- 所有的LAAP都使用零碎的内镜粘膜切除 (EMR) 进行切除,主要是用冷叉式脱落和陷尖凝固 (CAST).
- 在6个月的随访期间,没有发现复发或严重不良事件;CAST在LAAP中更常见,DMI II型的发病率更高,但没有显著的DMI (III-V).
结论:
- 由于其位置,大型腺瘤性解剖性息肉 (LAAP) 构成独特的内镜切除挑战.
- 尽管面临挑战,但通过内镜技术可以安全有效地管理LAAP.
- 对LAAP的内镜管理导致随访时没有复发,支持其临床实用性.
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