选择内镜切除技术用于治疗大结直肠病变
Oliver Cronin1,2,3, Francesco Vito Mandarino1,3, Michael J Bourke1,3
1Department of Gastroenterology and Hepatology, Westmead Hospital.
Current opinion in gastroenterology
|August 7, 2024
概括
内镜切除是大型非支柱状结直肠多瘤 (LNPCPs) 的主要治疗方法. 像内镜粘膜切除 (EMR) 和内镜亚粘膜解剖 (ESD) 这样的技术正在发展,改善了患者的治疗结果.
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
- 结肠直肠癌 预防 预防
背景情况:
- 大型非形结直肠多 (LNPCPs) 是显著的病变,占所有结直肠发现的1%.
- 这些息肉具有较高的先进组织学风险,包括高度生殖不良和下侵袭性癌症 (SMIC).
研究的目的:
- 批判性地评估目前LNPCPs的内镜切除技术.
- 审查LNPCPs内镜管理的不断变化的格局.
主要方法:
- 审查当前的内镜切除技术:传统的内镜粘膜切除 (EMR),冷诱导EMR (C-EMR),内镜亚粘膜切除 (ESD) 和内镜全厚切除 (EFTR).
- 分析趋势和证据支持选择性的基于算法的技术选择.
主要成果:
- 传统的EMR仍然很常见,对于LNPCP来说,C-EMR的趋势越来越大,尽管需要进一步的试验来确定C-EMR的限制.
- 内镜下粘膜切割 (ESD) 在结直肠应用中具有明确的作用.
- 现在,内镜全厚切除装置 (FTRD) 能够对精选的LNPCP进行治愈切除.
结论:
- 内镜切除是所有LNPCP的主要管理方法.
- 高质量的研究正在完善内镜技术,从而改善LNPCP管理中的患者结果.
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