非治疗性内镜下粘膜剖析:当前的概念,陷和未来的前景
João Santos-Antunes1,2,3
1Gastroenterology Department, Porto WGO Training Center, Centro Hospitalar S. João, 4200-319 Porto, Portugal.
Journal of clinical medicine
|April 12, 2025
概括
内镜下粘膜切割 (ESD) 有效地治疗消化道瘤,但可能导致非治愈的切除. 管理这些病例需要仔细考虑患者的因素和治疗选择,以获得最佳的瘤结果.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 内镜手术 进行内镜手术
背景情况:
- 内镜下粘膜解剖 (ESD) 是消化道瘤的主要治疗方法.
- 由于ESD在技术上很苛刻,由于病变的特征和内镜医生的经验,导致了大量的非治疗性切除.
- 不治愈性ESD后患者的最佳管理策略仍未确定.
研究的目的:
- 审查ESD对食道,胃和结直肠病变的治愈能力.
- 讨论经过非治愈性ESD的患者的管理.
- 突出预测残留疾病和指导补充治疗决策的挑战.
主要方法:
- 关于ESD疗效和程序后管理的研究的文献综述.
- 分析影响ESD切除结果的因素.
- 对非治愈病例的补充治疗选择 (手术,化疗,放射治疗) 的评估.
主要成果:
- 非治愈性ESD率因病变特征和操作人员技能而异.
- 在ESD后预测残留瘤是具有挑战性的,许多手术切除没有显示残留疾病.
- 非治愈性ESD的组织学标准对残留风险有不同的影响.
结论:
- 仔细的患者选择和程序技术对于最大限度地提高ESD治疗效果至关重要.
- 对于非治愈性ESD,需要个性化管理计划,平衡治疗效益与患者的并发病和生存.
- 需要进行进一步的研究,以改善残留疾病的预测,并完善非治愈性ESD病例的治疗算法.
相关概念视频
Endoscopic Procedures I: Esophagogastroduodenoscopy
40
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
40
Inflammatory Bowel Disease V: Surgical Management
67
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:
67
Endoscopic Procedures V: ERCP
42
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
42
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
32
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...
32
Peptic Ulcer Disease V: Surgical Management and Nursing Care
169
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
169
Barrett Esophagus-II: Clinical Manifestations and Management
77
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
77


