碎片内镜粘膜切除后的扩展监测:低风险患者初始监测的安全方法
Nikhita J Perry1, Sai Bhatte1, Joseph R Triggs2
1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Gastrointestinal endoscopy
|October 20, 2025
概括
针对大结肠多体的切片内镜粘膜切除 (EMR) 具有很高的复发率. 对于较低风险的病例,12个月的监测可能是安全的,减少不必要的后续检查.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 在瘤学瘤学.
背景情况:
- 切片内镜粘膜切除 (EMR) 是大型,非形结肠多的标准.
- 零碎EMR后的复发率在9%至31%之间.
- 目前的指导方针建议进行6个月的监测,对于低风险病例可能不需要.
研究的目的:
- 为了评估风险分层监测间隔的安全性和有效性,在大结肠多体的零碎EMR后进行监测.
- 为了确定是否延长监测到12个月是可行的选择患者.
- 为了确定与聚复发相关的因素,经过零碎的EMR.
主要方法:
- 对193名为≥20毫米结肠多的患者进行零碎EMR的回顾性审查 (2018-2021).
- 根据多重体特征,患者分为6个月或12个月的监测组.
- 监测组之间的复发率和相关因素的比较.
主要成果:
- 与12个月 (14.3%) 组相比,在6个月的监测组中复发率显著高 (31.5%).
- 最初的息肉的结核病组织学是与复发相关的唯一因素.
- 在6个月后复发的患者中,管状腺瘤的发生频率更高.
结论:
- 风险分层监测方法可以安全地将随访时间延长到12个月,对于较低风险的患者来说,分片后EMR可以安全地延长到12个月.
- 这一策略可以减少不必要的监测程序,而不会影响患者的护理.
- 管状病毒组织学是确定适当的监测间隔的关键因素.
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