对表面结肠直肠瘤进行凝浸泡内镜下粘膜解剖:一项回顾性研究,比较传统的内镜下粘膜解剖
Kenji Yamauchi1, Tomoki Inaba1, Takeshi Morimoto2
1Department of Gastroenterology Kagawa Prefectural Central Hospital Kagawa Japan.
DEN open
|October 13, 2025
概括
凝浸泡内镜下粘膜剖析 (Gi-ESD) 为结直肠病变提供了没有气体的清晰视图. 这种技术显示出较高的组织学R0切除率,对于困难病例非常有用.
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
- 大肠直肠癌治疗方法
背景情况:
- 凝浸泡内镜 (GIE) 提供浮力,引力和清晰的视野,避免气体吸入.
- 虽然有病例报告,但对结直肠凝浸泡内镜下粘膜解剖 (Gi-ESD) 的连续系列缺乏.
- 在连续系列中澄清Gi-ESD的实用性至关重要.
研究的目的:
- 评估Gi-ESD对结直肠瘤的有用性.
- 为了比较Gi-ESD与传统的内镜下膜剖析 (ESD).
主要方法:
- 一个单一中心的回顾性队列研究,连续接受结直肠ESD的患者.
- Gi-ESD涉及粘膜切口和粘膜下剖析在透明的凝下.
- 主要结局:整体和组织学R0切除率. 二次结果:手术时间,剖析速度,不良事件.
主要成果:
- 比起传统的ESD组 (231名患者),Gi-ESD组 (29名患者) 的瘤更大,结肠/上升结肠病变更多,难度因素更高.
- 在阻断切除或不良事件中没有显著差异.
- 组织学R0切除为Gi-ESD的96.6%,为传统ESD的88.7% (p=0.045在倾向得分匹配的队列中).
- 对于Gi-ESD,手术时间更长 (45分钟与29.5分钟相比).
结论:
- 对于沉浸或难以进入的结直肠病变,Gi-ESD是一种可行的替代方案.
- 该技术显示了与传统的ESD相比,类似的块切除和安全性.
- 在具有挑战性的病例中,Gi-ESD实现了显著更高的组织学R0切除率.
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