在复杂结肠病变的内膜管理中使用诱端内镜下粘膜剖析
Michael J Klingler1, Kamil Erozkan, Ali Alipouriani
1Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
Diseases of the colon and rectum
|September 12, 2024
概括
使用便宜的内镜陷尖用于晚期结肠病变的内镜下粘膜切割显示出良好的短期结果. 这种技术为昂贵的专用刀具提供了安全和可访问的替代方案,有可能改善患者对内镜切除的准入.
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:
- 对于晚期结肠病变,内镜下粘膜切割 (ESD) 通常需要专门的,昂贵的内镜刀.
- 内镜陷尖,一种廉价且广泛可用的工具,已在胃病变中显示出有效性,但对于结肠病变缺乏足够的数据.
研究的目的:
- 为了评估患者在使用内镜陷尖对晚期结肠病变进行内镜下层剖析 (ESD) 后的结果.
主要方法:
- 一个单一的第三级护理中心前性维护数据库的回顾性审查.
- 包括成人患者,结肠病变不适合陷多角切除术,在下内注射后接受ESD与陷尖切除.
- 排除了接受了带有内镜粘膜解剖的混合切除的患者.
主要成果:
- 121名患者接受了陷尖ESD,病变的平均尺寸为28.8毫米.
- 整体切除率为81.8%,平均手术时间为37.1分钟.
- 低并发症率 (1.70%穿孔) 和可接受的短期复发率 (7.89%).
结论:
- 对于晚期结肠病变的陷尖ESD显示了令人满意的短期结果.
- 这种技术提供了一个安全的,可访问的,和潜在的成本效益替代专业内镜刀.
- 可能增强内镜切除的采用,并改善患者的可访问性.
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