结肠直肠内镜全厚切除过程中的技术故障:"通过厚薄"的研究
Giulia Gibiino1, Cecilia Binda1, Luigi Giovanni Papparella2
1Gastroenterology and Digestive Endoscopy Units, Morgagni - Pierantoni Hospital, Forlì, and Maurizio Bufalini Hosptial, Cesena, Italy.
Endoscopy
|May 16, 2024
概括
使用FTRD系统用于结直肠病变的内镜全厚切除 (EFTR) 具有显著的技术故障率,主要是由于陷或剪贴问题. 救援内镜粘膜切除通常是成功的,但需要经验丰富的多学科团队.
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:
- 内镜全厚切除 (EFTR) 是一种公认的技术,用于管理非升高性结直肠病变.
- 虽然有效,但已经报告了全厚切除装置 (FTRD) 系统的技术挑战和故障.
- 量化和分类这些FTRD技术故障的详细数据是有限的.
研究的目的:
- 量化结直肠EFTR期间与FTRD系统相关的技术故障率.
- 为了分类遇到的技术故障类型.
- 评估FTRD失败后的后续管理,临床成功和并发症率.
主要方法:
- 在17个意大利中心进行了一项回顾性研究,这些中心在先进的内镜切除方面有经验.
- 分析了使用FTRD在2018年至2022年期间前性收集的连续结直肠EFTR程序的数据.
- 技术失败率,分类,后续治疗和结果是主要和次要终点.
主要成果:
- 在750个EFTR程序中,77名患者 (10.3%) 出现了技术故障.
- 故障被归类为I型 (陷不切割,53%),II型 (剪贴错误部署,31%),III型 (盖帽错位,16%).
- 在74%的病例中进行了救援内镜粘膜切除,分别在71%和64%的病例中实现了块切除和R0切除. 整体不良事件发生率为27.3%.
结论:
- 使用FTRD系统的结肠直肠EFTR具有很高的技术故障率和相关并发症.
- 有效的管理需要在救援和解剖技术方面的专业知识和多学科的方法.
- 高量和低量中心之间的失败率和结果是可比的.
相关概念视频
01:25Endoscopic Procedures II: Colonoscopy
89
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
89
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
77
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
77
01:26Endoscopic Procedures V: ERCP
196
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
196