大型突出的病变的结直肠内镜膜下剖析的结果:一项回顾性多中心研究
Hideyuki Chiba1, Ken Ohata2, Akimichi Hayashi1
1Gastroenterology, Omori Red Cross Hospital, Ota-Ku, Japan.
Endoscopy international open
|June 7, 2024
概括
结肠直肠内镜下粘膜切割 (ESD) 有效地治疗大,突出的病变 (LPL),但纤维化和肌肉收缩信号 (MRS) 增加了挑战. 开发先进的切除策略对于准确的病理评估至关重要.
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
- 在瘤学瘤学.
背景情况:
- 结肠直肠内镜下粘膜剖析 (ESD) 是早期结肠直肠癌的关键治疗方法,特别是大型突起的病变 (LPL).
- 在LPL治疗中的挑战,特别是下纤维化或肌肉收缩征兆 (MRS),需要进一步调查.
- 了解影响LPLESD结果的因素对于优化患者护理至关重要.
研究的目的:
- 调查大肠直肠ESD的大型突起病变 (LPL) 的结果.
- 确定影响ESD对LPL难度和成功的因素,包括瘤大小和亚粘膜纤维化.
- 对复杂的LPL案例评估道方法的有效性.
主要方法:
- 一项多中心回顾性研究分析了2012年6月至2023年5月期间526名患有542个LPL病变 (≥2厘米) 的患者的数据.
- 关键参数包括病变大小,手术时间,剖析速度,医生经验,纤维化,MRS和不良事件.
- 多变量分析评估了影响程序难度的因素,使用用于严重纤维化或MRS的道化方法.
主要成果:
- 在LPL中实现了高块切除率 (97.8%) 和治愈切除率 (78.6%).
- 纤维化和MRS分别存在于25%和18%的4厘米LPL中,频率增加与较大的瘤直径相关.
- 道方法在7.6%的病例中被使用;较大的瘤大小,纤维化,MRS和医生的经验影响了解剖速度.
结论:
- 对LPL的结肠直肠ESD提出了重大挑战,特别是与共存的纤维化和MRS.
- 识别这些复杂性对于成功治疗LPL至关重要.
- 需要开发更可靠的切除策略,以便对LPL进行准确的病理评估.
关键词:
结肠直肠癌是一种癌症.诊断和成像 (包括染色内镜,NBI,iSCAN,FICE,CLE等等)内镜切除 (多眼切除,ESD,EMRc,等等) 的方法内镜 下部消化道 下部消化道多胞胎 / 腺瘤 / ...更多相关视频
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