S-EMR:在厚度和高风险的脚型息肉中,首次经历了带着茎的内镜粘膜切除
Mojgan Forootan1, Alessandro Repici2, Mohsen Rajabnia3
1Gastroenterology and Liver Disease Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Surgery open science
|August 14, 2025
概括
结尾内镜粘膜切除 (S-EMR) 有效地去除大结肠聚体,显著减少了多角切除术后的出血. 这种先进的技术还有助于实现对恶性息肉的明确边缘,改善患者的治疗结果.
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
- 结肠直肠癌查 结肠直肠癌查
背景情况:
- 聚斑切除术后出血 (PPB) 是大息肉切除的常见并发症.
- 传统的多角切除术方法带有出血和不完全切除的风险,特别是在大型或恶性息肉.
研究的目的:
- 为了评估大尺度形和半形结肠片的支柱内镜粘膜切除 (S-EMR) 的疗效.
- 评估S-EMR减少PPB的潜力,以及对恶性息肉的重复干预或手术的需要.
主要方法:
- 这是一项前性,单臂的开放性研究,涉及48名具有特定多特征的患者 (巴黎类Ip/Ips,厚茎,大头,JNET 2B/3).
- 使用S-EMR去除息肉,包括带有下粘膜形成的提升切割技术和血管的预防性烧结.
- 术后监测即时并发症和延迟出血.
主要成果:
- 在接受S-EMR治疗的48名患者中,没有观察到早期或晚期PPB的情况.
- 诊断出四个大型半形息肉为腺癌,所有都具有明确的边缘,没有瘤亚粘膜入侵.
- 这项研究包括了各种多体大小和位置的患者,主要在西格结肠.
结论:
- S-EMR是一种安全有效的方法来切除具有挑战性的结肠多,包括那些粗茎,巨型,高风险或恶性.
- 这种技术显示了降低PPB的潜力,并促进了具有明显边缘的恶性息肉的完全切除.
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