在上部胃肠道内进行内镜 (SAFE) 切除的亚皮质病变算法
Sunil Gupta1,2, Julia Gauci1, Timothy O'Sullivan1,2
1Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.
Endoscopy
|July 19, 2024
概括
内镜切除为上部胃肠道亚皮质病变 (U-SELs) 提供了安全有效的治疗方法. 结构化算法对内镜 (SAFE) 切除方法指导这些病变的决策.
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:
- 完全切除上部胃肠道亚皮质病变 (U-SELs) 对于诊断和管理至关重要.
- 目前对U-SEL的指导方针缺乏准确性,手术选择带有显著的发病率.
- 为了解决这些局限性,开发了一种内镜切除算法 (SAFE).
研究的目的:
- 描述和报告对U-SEL的内镜 (SAFE) 切除结构化算法的结果.
- 评估U-SEL的内镜切除技术的安全性和有效性.
- 为管理U-SEL提供一个结构化的决策框架.
主要方法:
- 在115个月的时间里,U-SEL的预期招生.
- 术前成像包括计算机断层扫描和内镜超声波 (EUS) 来评估病变特征和肌肉自身 (MP) 的参与.
- 根据病变位置和疑似深度,采用了特定的内镜切除技术 (ESD,STER,e-EFTR).
主要成果:
- 在平均年龄为60.6岁的患者中切除了106个U-SEL.
- 技术成功率很高:食道U-SELs的97.6%,胃U-SELs的92.3%.
- 在13个月后没有观察到延迟出血,穿孔或复发;一些胃病例需要腹腔镜辅助或取回.
结论:
- 内镜切除是U-SELs的有效和安全的治疗方式.
- 该SAFE方法促进了结构化决策的U-SEL管理.
- 建议采用特定的内镜技术 (食道的STER,胃的ESD/e-EFTR),并考虑腹腔镜辅助.
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