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结肠多瘤中的失塑症和恶性病变:在加拿大为预留和丢弃策略做准备
Vishesh V Patel1, Robert Bechara1,2, Mandip Rai1,2
1Department of Medicine Queen's University Kingston Ontario Canada.
概括
对于小结肠多体,切除和丢弃策略可能是安全有效的. 大多数微小的息肉 (<5mm) 缺乏高度发育不良 (HGD),这表明可以考虑减少病理学审查.
科学领域:
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
- 在瘤学瘤学.
背景情况:
- 结肠镜检查对于检测和去除多胞体至关重要.
- 目前的加拿大实践要求对所有切除的息肉进行组织学检查.
- 对于精选的息肉,没有广泛采用"切除和丢弃"策略.
研究的目的:
- 在加拿大人口中描述结肠和它们的发育不良率.
- 评估"切除和丢弃"策略对小息肉的潜力.
主要方法:
- 从第三级护理医院的结肠镜和病理学报告的回顾性分析.
- 收集的数据包括多体大小,组织学和高度发育不良 (HGD) 或癌症的存在.
- 从2218次结肠镜检查中分析了2945个息肉.
主要成果:
- 管状腺瘤是最常见的多重体类型 (67.4%).
- 缩小型息肉 (1-5mm) 很少显示HGD (0.12%) 或癌症.
- 较大的息肉 (>10毫米) 有显著更高的HGD (16.02%) 和癌症 (2.76%).
结论:
- 一个"切除和丢弃"的策略保证了进一步评估这个群体中的缩小型息肉.
- 目前对病理学评估的建议可能是资源密集的.
- 未来的研究可以根据多体特征优化查间隔,以降低成本而不会影响患者的结果.
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