对结直肠瘤进行内镜切除.
Yuichiro Hirai1, Naoya Toyoshima1, Yutaka Saito1
1Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Digestion
|November 4, 2024
概括
结肠直肠瘤的去除已经取得了进展,用于小病变的冷多角切除术和用于较大的病变的水下内镜粘膜切除术. 新的技术和设备提高了T1-结直肠癌去除的安全性和有效性.
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
背景情况:
- 结直肠瘤的内镜切除技术正在不断进步.
- 对于小小的病变 (<10毫米) 发生了明显的转向"冷革命" (冷多角切除术).
- 水下内镜粘膜切除 (EMR) 正在获得中等到大病变 (≥10毫米) 的吸引力.
研究的目的:
- 审查结直肠瘤内镜切除的演变.
- 为突出关闭膜缺陷的关闭技术和设备的进步.
- 讨论内镜切除在治疗T1-结直肠癌 (T1-CRC) 中的作用.
主要方法:
- 审查当前的内镜切除技术,包括冷多角切除术,EMR和内镜膜下切割 (ESD).
- 讨论新出现的关闭技术和装置,用于切割后的粘膜缺陷.
- 对T1-CRC.内镜切除越来越多的应用进行分析.
主要成果:
- 对于小小的病变来说,冷多角切除术是标准的,而对于较大的病变来说,水下EMR是一种替代方案.
- 内镜下粘膜切割 (ESD) 变得越来越可行,并在全球范围内被采用,对于大型病变 (≥20毫米) 已证明安全性和有效性.
- 关闭技术和设备的进步正在解决切割后更大,更复杂的缺陷.
结论:
- 结直肠瘤的内镜切除技术正在迅速发展,提供更安全,更有效的选择.
- 采用诸如冷多角切除术,水下EMR和ESD等技术正在扩大,包括T1-结肠直肠癌.
- 关闭方法和设备的持续创新支持复杂的内镜切除的管理.
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