聚角切除术后结直肠出血:当前的策略和前进的路径
Nilanga Nishad1, Mo Hameed Thoufeeq1,2
1Department of Gastroenterology, Sheffield University Hospitals NHS Trust, Sheffield, United Kingdom.
Clinical endoscopy
|December 25, 2024
概括
预防内镜后粘膜切除出血是复杂的. 对高风险患者来说,选择性剪切可能具有成本效益,但由于混合结果,通常不建议进行例行预防.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 大肠直肠癌查检查
背景情况:
- 内镜切除粘膜后 (EMR) 流血是一种显著的并发症.
- 风险因素包括多体大小,病变位置 (右结肠),瘤类型,抗凝剂使用和患者的并发症.
研究的目的:
- 审查目前对EMR后出血的预防策略.
- 评估各种预防措施的有效性和成本效益.
- 确定未来研究预防EMR后出血的领域.
主要方法:
- 审查现有的研究和对EMR后出血的元分析.
- 分析预防性干预措施,如剪切,和凝血.
- 对不同策略的成本效益数据的评估.
主要成果:
- 常规的预防性剪切通常不会降低出血风险,但可能有利于大近端病变.
- 高风险患者的选择性切割是具有成本效益的;普遍切割不是.
- 与上升结肠/阴相比,横向结肠病变的出血风险似乎较低.
结论:
- 对于EMR后出血的最佳预防疗法尚未确立.
- 选择性剪切对高风险个体来说是具有成本效益的.
- 需要进一步的研究来制定明确的指导方针和完善预防策略.
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