对于中等大小 (10-20毫米) 表面非腹膜十二指甲状腺上皮瘤,最优的内镜切除方法是什么? 一个系统性审查
Digestion
|January 30, 2026
概括
对于中等大小的表面非膜十二指甲状腺瘤 (SNADETs),内镜下粘膜切割 (ESD) 提供了高切除率,但传统的内镜粘膜切除 (EMR) 和水下EMR (UEMR) 是更安全的第一线选择,因为不良事件较少.
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:
- 中等大小 (10-20毫米) 表面非腹膜十二指甲状腺上皮瘤 (SNADETs) 存在治疗挑战.
- 存在各种内镜切除 (ER) 技术,包括传统的内镜粘膜切除 (EMR),水下EMR (UEMR) 和内镜亚粘膜切除 (ESD).
- 对于SNADET的最佳ER方法仍然不确定.
研究的目的:
- 系统地审查和比较不同ER技术对中型SNADET的结果.
- 评估块切除率,R0切除率以及与EMR,UEMR和ESD相关的不良事件.
- 根据安全性和有效性,确定SNADETs最合适的第一线治疗方法.
主要方法:
- 对2013年1月至2023年8月发表的研究进行系统审查.
- 包括14个队列研究 (3个多中心,11个单中心) 报告了SNADETs ≤20mm的ER结果.
- 数据提取的重点是区块/R0切除率,延迟出血,穿孔和复发.
主要成果:
- 与EMR (82.7%,54.2%) 和UEMR (74.8%,50.6%) 相比,ESD在多中心研究中显示了较高的集成块 (94.6%) 和R0切除率 (80.9%).
- 在不同技术中,延迟出血率相似 (EMR 3.3%,UEMR 3.2%,ESD 5.4%).
- 与EMR (1.1%,0.3%) 和UEMR (0.0%,0.0%) 相比,ESD显示了更高的手术内 (7.9%) 和延迟穿孔 (3.0%) 的发生率. 复发率为EMR/UEMR的5%左右,ESD的0%左右.
结论:
- 内镜下粘膜切割 (ESD) 为SNADETs提供了优越的切割质量.
- 传统的内镜粘膜切除 (EMR) 和水下EMR (UEMR) 提供了有利的结果,显著减少了不良事件.
- 建议EMR和UEMR作为中等尺寸SNADET的适当一线治疗选择,因为它们的安全性和有效性.
相关概念视频
Systematic Sampling Method
13.3K
Sampling is a technique to select a portion (or subset) of the larger population and study that portion (the sample) to gain information about the population. Data are the result of sampling from a population. The sampling method ensures that samples are drawn without bias and accurately represent the population. Because measuring the entire population in a study is not practical, researchers use samples to represent the population of interest.
Systematic sampling is one of the simplest methods...
Systematic sampling is one of the simplest methods...
13.3K
Review and Preview
8.4K
In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
Percentiles are a type of fractile that partition data into...
8.4K
Review and Preview
11.3K
Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
11.3K
The Intermediate Value Theorem
272
The Intermediate Value Theorem is a foundational result in calculus that guarantees the existence of solutions within certain intervals for continuous functions. Formally, the Intermediate Value Theorem states that if a function f is continuous on the closed interval [a, b], and if N is any value between f(a) and f(b), then there exists at least one c ∈ (a, b) such that f(c) = N. This theorem is instrumental in proving the existence of roots and in analyzing the behavior of continuous...
272
Disassembly of Intermediate Filaments
2.7K
Intermediate filaments (IFs) do not undergo spontaneous disassembly. Enzymes, kinases, and phosphatases add and remove phosphates from specific sites to regulate their disassembly. The IF concentration in the cytoplasm also regulates the disassembly. If the concentration crosses a threshold, it activates the protein kinases in the vicinity, allowing the phosphorylation of IFs.
Keratin proteins, found at the cell periphery near cell junctions, undergo a cycle of assembly and disassembly. In Type...
Keratin proteins, found at the cell periphery near cell junctions, undergo a cycle of assembly and disassembly. In Type...
2.7K
Types of Intermediate Filaments
4.9K
The intermediate filaments are an essential component of the cytoskeleton. Presently six types of intermediate filament have been identified. Type I and II are acidic and basic keratin proteins. Type III is of mesodermal origin and comprises four proteins: vimentin, desmin, glial fibrillary acidic protein (GFAP), and peripherin. Vimentin is commonly found in mesenchymal cells, desmin in muscle cells, GFAP in astrocytes, while peripherin is found in peripheral nervous system neurons (PNS). Type...
4.9K


