包括乳头在内的内镜下粘膜切割的可行性 (带视频)
Naohisa Yahagi1, Yusaku Takatori1, Motoki Sasaki1
1Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.
概括
包括乳头在内的内镜下膜剖析 (ESDIP) 显示出对十二指腺瘤的可行性. 这种微创手术技术为手术提供了潜在的替代方案,其复发率为15%,在12个月后的存活率为96%.
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:
- 内镜乳头切除术 (EP) 对十二指肠瘤的病变大小和局部复发有局限性.
- 内镜下粘膜切割 (ESD) 是一种用于胃肠病变的先进技术.
研究的目的:
- 评估包括乳头在内的内镜下膜剖析 (ESDIP) 对十二指肠瘤的可行性.
- 评估ESDIP作为手术切除的替代方案.
主要方法:
- 从2010年8月到2024年1月接受ESDIP的54名患者的回顾性分析.
- 评估患者和病变特征,临床结果和病理发现.
- 评估内镜逆行胆血管细胞造影 (ERCP) 用于预防不良事件和计算复发和生存率.
主要成果:
- 在96%的病例中成功切除 (平均病变大小为39毫米),其中96%的血栓切除率.
- 并发症包括手术内穿孔 (8例),延迟出血 (10例) 和延迟穿孔 (1例).
- 在ERCP后的胰腺炎发生在25%的患者中;12个月累积局部复发率为15%,整体存活率为96%.
结论:
- 包括乳头在内的内镜下粘膜切割 (ESDIP) 是对涉及乳头的十二指甲瘤的一种可行的内镜治疗方法.
- 通过ESDIP,可以替代胰腺突切除术,从而减少对大手术的需要.
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