2024年的结肠多眼术:热或冷?
K Ferdinande1, L Desomer2, D De Looze1
1Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
与热陷多角切除术 (HSP) 相比,冷陷多角切除术 (CSP) 对小结直肠多瘤更安全,同样有效. 广泛采用CSP可以减少结肠镜检查结肠直肠癌 (CRC) 期间的不良事件.
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:
- 结肠直肠癌 (CRC) 是全球癌症死亡的主要原因.
- 结肠镜检查与内透视多角切除术对于预防CRC进展至关重要.
- 不完整的聚切除可以导致结肠镜后结肠直肠癌 (PCCRC).
研究的目的:
- 审查热陷多角切除术 (HSP) 与冷陷多角切除术 (CSP) 对于微小和小结直肠多瘤的安全性.
- 为突出CSP作为一个潜在的更安全的替代方案,HSP用于例行多角切除术.
主要方法:
- 审查最近的高质量研究,比较HSP和CSP的疗效和安全性.
- 分析不良事件概况,包括出血和穿孔风险.
- 考虑临床实践趋势和患者特定因素.
主要成果:
- 在10毫米以下的息肉中,CSP表现出与HSP相似的疗效和更高的安全性.
- CSP适用于日常实践中遇到的大多数息肉.
- CSP提供了有利的风险效益比,特别是对于服用抗凝药的患者.
结论:
- 由于其安全优势,CSP是切除微小和小结直肠息肉的首选技术.
- 增加CSP的使用可以显著减少与内镜多角切除相关的不良事件.
- CSP的应用可能会扩展到更大的病变和特定的患者群体.
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