Dos Santos Carlos Eduardo Oliveira, Pereira-Lima Júlio Carlos, Onófrio Fernanda de Quadros
Gastroenterology and Endoscopy Department, Hospital Santa Casa, Bagé, RS, Brazil.
Gastroenterology and Endoscopy Department, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA/Santa Casa de Porto Alegre, RS, Brazil.
GE Port J Gastroenterol. 2016 Feb 23;23(4):197-207. doi: 10.1016/j.jpge.2016.01.001. eCollection 2016 Jul-Aug.
In the last years, a distinctive interest has been raised on large polypoid and non-polypoid colorectal tumors, and specially on flat neoplastic lesions ≥20 mm tending to grow laterally, the so called laterally spreading tumors (LST). Real or virtual chromoendoscopy, endoscopic ultrasound or magnetic resonance should be considered for the estimation of submucosal invasion of these neoplasms. Lesions suitable for endoscopic resection are those confined to the mucosa or selected cases with submucosal invasion ≤1000 μm. Polypectomy or endoscopic mucosal resection remain a first-line therapy for large colorectal neoplasms, whereas endoscopic submucosal dissection in high-volume centers or surgery should be considered for large LSTs for which en bloc resection is mandatory.
近年来，人们对大的息肉样和非息肉样结直肠肿瘤，特别是对直径≥20mm、倾向于侧向生长的扁平肿瘤性病变，即所谓的侧向发育型肿瘤（LST）产生了独特的兴趣。对于评估这些肿瘤的黏膜下浸润，应考虑进行实体或虚拟色素内镜检查、超声内镜检查或磁共振检查。适合内镜切除的病变是那些局限于黏膜层的病变，或黏膜下浸润≤1000μm的特定病例。息肉切除术或内镜黏膜切除术仍然是大肠大肿瘤的一线治疗方法，而对于必须整块切除的大LST，在高容量中心应考虑进行内镜黏膜下剥离术或手术治疗。
