Huang Chen, Huang Ren-Xiang, Xiang Ping, Qiu Zheng-Jun
Department of General Surgery, Affiliated First People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
Clin Invest Med. 2012 Aug 4;35(4):E158-64. doi: 10.25011/cim.v35i4.17147.
Endoscopic submucosal dissection (ESD) has been applied to, and gradually standardized for, early gastric cancers; however, it has not yet been widely used for treatment of colorectal neoplasms. Compared with gastric ESD, the thinner colorectal wall and winding nature of the colon make colorectal ESD a much more difficult operative technique. Despite greater risks of postoperative complications, particularly perforation of the colon, more and more endoscopists are making an effort to study this new technique in terms of its capability of larger neoplastic resection, higher en bloc resection rate and lower local recurrence rate of neoplasms in comparison with other endoscopic treatments. Thus, colorectal ESD may become the standard treatment for early colorectal neoplasms in the future. This review article discusses the current research on endoscopic submucosal dissection for colorectal neoplasms. Please see supplementary files for the accompanying video ESD with snare.
内镜黏膜下剥离术(ESD)已应用于早期胃癌并逐渐标准化;然而,它尚未广泛用于结直肠肿瘤的治疗。与胃ESD相比,结直肠壁更薄且结肠呈迂曲状,这使得结直肠ESD成为一种难度大得多的手术技术。尽管术后并发症风险更大,尤其是结肠穿孔,但与其他内镜治疗相比,越来越多的内镜医师正努力研究这项新技术,因为它能够切除更大的肿瘤、实现更高的整块切除率以及更低的肿瘤局部复发率。因此,结直肠ESD未来可能会成为早期结直肠肿瘤的标准治疗方法。这篇综述文章讨论了目前关于结直肠肿瘤内镜黏膜下剥离术的研究。有关圈套器辅助ESD的随附视频,请参阅补充文件。