结肠内镜下粘膜解剖 (ESD) 后癌症,非治愈性切除,不良事件和手术的发生率-来自大型国际多中心研究的结果
Rahul Karna1, Jonathan Colón Sánchez2, Kevan Josloff3
1Division of Gastroenterology & Hepatology, University of Minnesota, Minneapolis, MN, 55414, USA. rahulkarnagovind@gmail.com.
Digestive diseases and sciences
|December 16, 2025
概括
结肠病变的内镜下层剖析 (ESD) 经常显示良性病理,癌症病变的非治愈切除率 (NCR) 高. 优化ESD技术和病变选择对于结肠癌治疗至关重要.
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:
- 对于怀疑表面侵袭的结肠癌,内镜下粘膜切除 (ESD) 优先于内镜粘膜切除 (EMR).
- 关于ESD利用率,包括癌症和非治愈切除率 (NCR) 的数据有限.
- 精确的患者选择对于优化ESD结果至关重要.
研究的目的:
- 评估ESD在一个大规模的西方群体中的利用和结果.
- 为了确定癌症的发生率,NCR,以及在结肠ESD后的后续手术.
- 在结肠ESD程序中识别NCR的预测因素.
主要方法:
- 在多个中心对547个连续使用ESD治疗的结肠病变进行了回顾性分析.
- 对组织病理学发现的评估,包括癌症和高度发育不良.
- 对NCR率,手术干预率和不良事件的评估.
主要成果:
- 组织病理学证实了12%的病变是癌症;24.6%的病变显示出高度的发育不良.
- 总体NCR率为59.1%的患者和39%的病变.
- 在7.6%的NCR病例中,需要手术,不良事件发生率为8.8%.
结论:
- 这个队列中的大多数结肠ESD治疗了良性病理,癌症病变的NCR率很高.
- 尽管NCR高,整体手术率仍然很低,这表明ESD的安全性.
- 完善病变选择标准和优化ESD技术是必要的,以提高效率和安全性,可能与EMR的性能相匹配.
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