对表面非脉冲双上皮瘤进行内镜切除
Hye Kyung Jeon1, Gwang Ha Kim1
1Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Gut and liver
|September 4, 2024
概括
人们越来越多地发现表面非膜十二指甲上皮瘤 (SNADETs). 内镜切除是关键的,采用冷陷多角切除 (CSP) 和内镜膜下切割 (ESD) 等技术,根据瘤大小和类型进行选择.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 手术瘤学手术瘤学
背景情况:
- 由于先进的内镜成像,表面非腹膜十二指甲上皮瘤 (SNADETs) 的检测正在增加.
- 内镜切除是主要的治疗方法,包括冷陷多角切除 (CSP),常规内镜粘膜切除 (cEMR),水下EMR (uEMR) 和内镜亚粘膜切除 (ESD) 等技术.
研究的目的:
- 审查SNADETs的内镜切除技术的现状和最近的进展.
- 讨论与十二指肠内镜切除相关的挑战和风险.
- 为根据病变特征选择适当的切除方法提供指导.
主要方法:
- 对SNADETs进行内镜切除的当前文献和指导方针的审查.
- 分析不同的内镜切除技术 (CSP,cEMR,uEMR,ESD).
- 评估影响治疗决策的因素,包括瘤大小,疑似恶性瘤和解剖学考虑.
主要成果:
- 与其他器官相比,双胞胎内镜切除具有独特的挑战和更高的不良事件风险.
- 损伤大小决定了技术:CSP,cEMR,uEMR ≤10毫米;cEMR/uEMR 1020毫米;零碎EMR/ESD>20毫米.
- 怀疑癌瘤>30毫米,需要考虑ESD或手术切除.
结论:
- 对于SNADETs的治疗选择需要逐个案例的方法.
- 平衡不良事件的风险与需要进行块切除的需求至关重要.
- 优化内镜切除策略对于管理日益增长的SNADET发病率至关重要.
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