胃下皮质瘤内镜治疗的进步
Osamu Goto1,2, Kazutoshi Higuchi1, Eriko Koizumi1
1Department of Gastroenterology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Gut and liver
|January 8, 2025
概括
内镜切除是胃亚皮质瘤 (SETs) 的最小侵入性选择. 治疗选择取决于SET大小,从观察到先进的内镜或手术技术,以获得最佳的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 在瘤学瘤学.
背景情况:
- 胃下皮质瘤 (SETs) 构成恶性瘤的风险,需要谨慎管理.
- 口腔柔性内镜为SETs的局部切除提供了一种最少的侵入性方法.
- 目前的治疗策略主要以瘤大小和组织学特征为指导.
研究的目的:
- 审查和概述当前对胃亚皮质瘤 (SETs) 的内镜和外科治疗策略.
- 为了将瘤大小与适当的切除技术相关联,包括内镜和联合腹腔镜-内镜方法.
- 讨论内镜在SET治疗中的演变作用及其对患者生活质量的影响.
主要方法:
- 对胃亚皮质瘤的内镜和外科切除技术的文献综述.
- 基于病变大小的SET管理的分类 (例如,<1厘米,1-3厘米,3-5厘米,>5厘米).
- 不同的内镜切除方式 (EMR,ESD,EEE,STET,PETR,EFTR) 和腹腔镜和内镜合作手术 (LECS) 的比较.
主要成果:
- 微小的SET (<1厘米) 通常通过监视来管理,除了需要EMR或ESD的表面病变.
- 小型SETs (1-3厘米) 可以通过内镜核化技术或EFTR进行治疗,以完全去除.
- 适度的SET (3-5厘米) 通常需要腹腔外科干预,而LECS提供了一个不那么侵入性的替代方案.
结论:
- 胃SET的切除技术的选择严重依赖于瘤大小,需要量身定制的方法.
- 内镜全厚切除和LECS对于特定的SET大小来说是有价值的,不那么侵入性的选择.
- 预计内镜诊断和技术的进步将扩大内镜治疗指示,改善患者的治疗结果.
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