在巴雷特食道中去除可见病变的最佳技术:何时使用内镜粘膜切除或内镜亚粘膜剖析?
Digestive surgery
|February 18, 2026
概括
对巴雷特食道 (BE) 的内镜切除 (ER) 涉及内镜粘膜切除 (EMR) 和内镜亚粘膜切除 (ESD). 由于有限的比较证据,对可见病变的最佳技术选择仍然不清楚.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 在瘤学瘤学.
背景情况:
- 食道腺癌 (EAC) 的发病率正在上升,巴雷特食道 (BE) 是一个关键的前体.
- 内镜切除 (ER) 是BE可见病变的标准,提供分期和治疗.
- 治疗急诊对于治疗发育不良症和早期EAC至关重要.
研究的目的:
- 在BE病变中比较内镜粘膜切除 (EMR) 和内镜亚粘膜剖析 (ESD).
- 在临床实践中澄清最佳ER技术选择.
- 在特定场景中解决缺乏比较证据的问题.
主要方法:
- 审查当前的ER技术:EMR和ESD.
- 在治疗决策中分析病变大小,形态和下粘膜入侵.
- 确定缺乏关于ER方法的共识的临床场景.
主要成果:
- 对于较小的表面病变,EMR是安全有效的,但对于较大的病变可能需要分片切除.
- 虽然ESD允许不论大小的内块切除,但在技术上要求较长的手术时间.
- 对于特定情况下的ESD存在共识 (例如,疑似入侵,纤维化),而EMR则是其他情况下的标准.
结论:
- 关于某些与BE相关的病变的最佳ER技术存在重大知识差距.
- 需要进一步的比较研究来指导治疗决策.
- 澄清ER指示将改善患者在BE管理中的结果.
相关概念视频
Barrett Esophagus-II: Clinical Manifestations and Management
1.2K
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
1.2K
Barrett Esophagus-I: Introduction
976
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
976
Endoscopic Procedures I: Esophagogastroduodenoscopy
1.4K
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
1.4K
Gastroesophageal Reflux Disease II: Clinical Features and Management
997
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
997
Esophageal Strictures-II: Clinical Features and Management
726
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
726

