对靠近结肠病变进行内镜下粘膜剖析:一种有效的治疗选择
Ludovico Alfarone1, Roberta Maselli1,2, Cesare Hassan1,2
1Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Endoscopy international open
|March 20, 2025
概括
内镜下粘膜切割 (ESD) 对于大近端结肠聚体是有效的,提供高治愈切除率. 这种方法平衡了不良事件风险与避免早期结直肠癌 (CRC) 不必要的手术的好处.
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:
- 大型近位结肠多通常经历断片内镜粘膜切除 (EMR) 由于不良事件 (AE) 风险和较低的粘膜下侵袭性癌症 (SMIC) 率.
- 在早期结直肠癌 (CRC) 的非治愈切除术中,EMR存在需要手术的风险.
研究的目的:
- 为了评估内镜下膜解剖 (ESD) 对于具有SMIC风险的靠近结肠病变的结果.
- 评估ESD在管理这些具有挑战性的病变方面的有效性和安全性.
主要方法:
- 未来将116名连续接受ESD治疗的患者纳入SMIC风险的临近结肠病变.
- 主要结局:整体,R0和治愈切除率. 二次结果:住院时间,副作用,需要手术和复发率.
主要成果:
- 实现了高的 en bloc (84.5%),R0 (78.4%) 和治愈切除 (72.4%) 率.
- 在25%的病变中发现了T1腺癌. 只有9.5%需要二次手术,没有AE需要手术干预.
- 观察到较低的复发率 (3.1%在6个月,1.2%在36个月),所有都通过内镜进行管理.
结论:
- 在专家手中,ESD对临近结肠病变具有SMIC风险的有效和安全.
- 它在AE风险和避免不必要的手术的好处之间提供了有利的平衡,即使是早期的CRC.
更多相关视频
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
302
09:42Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
18.6K
相关概念视频
01:21Inflammatory Bowel Disease V: Surgical Management
71
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
71
01:29Drugs for Treatment of Ulcerative Colitis in IBD
114
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
114
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
38
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
38