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在水下内镜粘膜切除表面非囊双胞胎上皮瘤 ≤20毫米的Tip-In

Tomoya Ueda^1,2, Shunsuke Yoshii¹, Kazuki Matsuyama¹

¹Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.

Journal of gastroenterology and hepatology

|July 25, 2025

概括

这种新型的水下内镜粘膜切除 (UEMR) 技术显著改善了表面非膜十二指甲上皮瘤 (SNADETs) 的R0切除率,长度高达20mm,不增加不良事件.

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:

表面非型十二指甲上皮瘤 (SNADETs) 通常通过水下内镜粘膜切除 (UEMR) 进行治疗.
传统的UEMR (C-UEMR) 在实现完全切除瘤 (R0切除) 方面存在局限性.
开发了一种新的"tip-in UEMR"技术,以改善切除边缘.

研究的目的:

评估TIP-IN UEMR技术对于≤20mm的SNADET的有效性.
为了比较TIP-IN UEMR的R0切除率与C-UEMR.
评估这两种技术的不良事件和局部复发率.

主要方法:

在2023年1月至2024年10月期间对待的≤20mm SNADETs的单中心回顾性研究.
尖端UEMR (19个瘤) 与C-UEMR (128个瘤) 的比较.
主要终点:R0切除率;次要终点:不良事件和局部复发.

主要成果:

提示式UEMR实现了明显更高的R0切除率 (84.2%),而不是C-UEMR (53.9%,p=0.013).
没有观察到随着UEMR的提示出现不良事件的显著增加.
提示性UEMR在10-20mm大小的瘤中显示出更高的R0率 (p=0.049) 并且是R0切除的独立因素 (OR,5.15;p=0.018).
当地复发率为C-UEMR的3.9%,而UEMR滴入时为0%.

结论:

提示式UEMR对于SNADETs≤20mm.是一个有价值的技术.
这种技术对大小为10-20mm的SNADETs特别有益.
提示UEMR提供了改进的R0切除率,并可能减少局部复发.

关键词:

十二指甲瘤是什么意思进行内镜粘膜切除.切除边缘的切除边缘是一个切除边缘.

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