一种新的水下注射内镜粘膜切除技术对大肠直肠多瘤≥10毫米的程序结果
Yuichiro Hirai1, Naoya Toyoshima1, Hiroyuki Takamaru1
1Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Endoscopy
|November 20, 2024
概括
水下注射EMR (UIEMR) 提供了T1结直肠癌 (CRC) 的解决方案,通过在内镜切除过程中实现下注射. 这种新的技术实现了高块切割率和适当的垂直边缘,证明了安全和有效.
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
- 结肠直肠癌研究研究
背景情况:
- 水下内镜粘膜切除 (UEMR) 缺乏粘膜下注射,引发了人们对实现T1结直肠癌 (CRC) 足够边际的担忧.
- 适当的切除边缘对于有效的T1CRC治疗至关重要.
研究的目的:
- 开发和评估一种新的水下注射EMR (UIEMR) 技术,将UEMR与下注射相结合.
- 评估UIEMR的安全性和有效性,以实现T1 CRC的适当垂直边际.
主要方法:
- 对135个病变的回顾性分析,这些病变来自于接受UIEMR治疗的患者,以检测非形结直肠多体 (≥10毫米).
- 评估封锁,R0,RX和R1切除率以及不良事件.
- 在七个T1 CRC案例中评估垂直边缘距离.
主要成果:
- 在127个病变中实现了高块切除率 (94.1%).
- R0和RX切除率分别为68.1%和31.1%,只有一个R1切除 (0.7%).
- 副作用的发生率很低 (1.5%),有两例延迟出血. 所有七个T1CRC病例都有自由垂直边缘 (中位数为1140μm).
结论:
- UIEMR 显示了 en bloc 切除的高成功率,并确保了足够的垂直利率.
- 这种技术是T1CRC的潜在可行的选择,特别是对于较小的病变.
- 需要进一步的研究来验证UIEMR在T1 CRC管理中的作用.
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