AGA临床实践更新关于非腹双关节病变的最新情况:专家评价
Michael J Bourke1, Simon K Lo2, Ross C D Buerlein3
1Gastroenterology and Hepatology, Westmead Hospital, Westmead, New South Wales, Australia; The University of Sydney, Sydney, New South Wales, Australia.
Gastroenterology
|November 15, 2024
概括
这份专家评价提供了关于管理非型十二指息肉的指导,强调腺瘤的内镜切除. 它详细介绍了这些常见的胃肠病变的风险分层,切除技术,监测和并发症管理.
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
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 在高端内镜检查中,多达5%的患者偶尔会发现非囊性十二指息肉.
- 腺瘤占这些病变的10%-20%,存在恶性转变的风险.
- 建议进行内镜切除,但不良事件发生率接近15%.
研究的目的:
- 提供专家指导,评估和风险分层的十二指息肉患者.
- 概述内切除和监测十二指腺瘤的最佳方法.
- 解决并发症的管理和确定未来研究的领域.
主要方法:
- 由美国胃肠道学会 (AGA) 委托的专家审查.
- 基于文献审查和专家意见的指导,而不是正式的系统审查.
- 开发最佳实践 临床管理的建议声明.
主要成果:
- 模仿腺瘤的非新生病变需要仔细评估;切除仅用于症状或出血病变.
- 详细的内镜检查和病变表征对于治疗规划至关重要.
- 如果最近没有进行,建议对患有十二指肠腺瘤的患者进行结肠镜检查.
结论:
- 内镜切除是十二指腺腺瘤的首选治疗方法,因为与手术相比,患病率较低.
- 应该使用个性化的切除方法 (热与冷的陷,水下EMR) 来最大限度地降低出血风险.
- 切除后的监测至关重要,最初6个月后进行随访,以监测复发情况.
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