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[结肠镜检查在结直肠癌及癌前病变的筛查、随访及治疗中的应用]

[Colonoscopy in the screening, follow-up and treatment of colorectal cancer and precursor lesions].

作者信息

Pellisé Maria

机构信息

Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, España.

出版信息

Gastroenterol Hepatol. 2015 Sep;38 Suppl 1:71-7. doi: 10.1016/S0210-5705(15)30022-4.

Abstract

Endoscopic polypectomy reduces the incidence of colorectal cancer and mortality due to this disease. Interval cancer is the marker par excellence of the effectiveness and quality of screening and surveillance programs. Interval cancer is defined as colorectal cancer appearing after a negative screening or surveillance test (whether colonoscopy or another type of test) for colorectal cancer and before the recommended date of the following screening test. It has been estimated that up to 75% of interval colorectal cancers may be due to poor endoscopic technique. Therefore, to reduce mortality from this disease, diagnostic and therapeutic colonoscopy must be carried out with high quality standards. In the latest congress of the American Gastroenterological Association, presentations were given on studies designed to analyse interval cancer and its possible causes, as well as to evaluate endoscopic techniques that could improve detection of polyps or optimize their complete resection. Likewise, strategies have begun to be evaluated that would allow rationalization of efforts and resources to achieve screening of the maximum number of individuals, with high quality standards, but without completely overloading the healthcare system. Finally, the congress also devoted substantial space to presentations on the management of post-polypectomy complications and large polyps.

摘要

内镜下息肉切除术可降低结直肠癌的发病率及因该病导致的死亡率。间隔期癌是筛查和监测项目有效性及质量的卓越标志。间隔期癌定义为在结直肠癌筛查或监测试验(无论是结肠镜检查还是其他类型的检查)结果为阴性后、下一次推荐筛查日期之前出现的结直肠癌。据估计,高达75%的间隔期结直肠癌可能归因于内镜技术欠佳。因此,为降低该病的死亡率,诊断性和治疗性结肠镜检查必须按照高质量标准进行。在美国胃肠病学会的最新大会上,有人介绍了旨在分析间隔期癌及其可能病因的研究,以及评估可改善息肉检测或优化其完全切除的内镜技术。同样,已开始评估一些策略,这些策略将使努力和资源合理化,从而在高质量标准下实现对尽可能多的个体进行筛查,同时又不会使医疗系统完全不堪重负。最后,大会还留出大量篇幅用于介绍息肉切除术后并发症及大息肉的处理。

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