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结肠镜检查中的先进治疗与成像:用于完整切除的袋形创建方法及用于结肠镜更好检测早期肿瘤性病变的联动彩色成像。

Advanced Treatment and Imaging in Colonoscopy: The Pocket-Creation Method for Complete Resection and Linked Color Imaging for Better Detection of Early Neoplastic Lesions by Colonoscopy.

作者信息

Yamamoto Hironori, Shinozaki Satoshi, Hayashi Yoshikazu, Miura Yoshimasa, Khurelbaatar Tsevelnorov, Osawa Hiroyuki, Lefor Alan Kawarai

机构信息

Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.

Department of Medicine, Jichi Medical University, Shimotsuke,, Shinozaki Medical Clinic, Utsunomiya, Japan.

出版信息

Clin Endosc. 2019 Mar;52(2):107-113. doi: 10.5946/ce.2018.189. Epub 2019 Jan 10.

Abstract

Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficial colorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all been developed and used worldwide. The pocket-creation method facilitates the resection of tumors in difficult and routine locations. Early detection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques. However, the detection of small, flat-shaped, or faded color lesions remains difficult. Linked color imaging, a novel multi-light technology, facilitates the recognition of minor differences in tissue by enhancing the color contrast between early colorectal neoplasms and surrounding normal mucosa in a bright field of view. The most striking feature of linked color imaging is its ability to display the color of early neoplastic lesions as distinct from inflammatory changes, both of which have similar "redness" when viewed using white light imaging. To increase the detection rate of neoplasms, linked color imaging should be used from the outset for endoscopic observation. Early detection of superficial colorectal tumors can result in decreased mortality from colorectal cancer and maintain a good quality of life for patients.

摘要

早期发现并切除肿瘤性病变是降低结直肠癌死亡率的关键目标。浅表性结直肠肿瘤切除术、冷圈套息肉切除术、内镜黏膜切除术和内镜黏膜下剥离术在全球范围内均已得到发展并应用。袋状创建法有助于在困难和常规部位切除肿瘤。早期发现是最大限度发挥内镜技术最新进展益处的最重要的第一步。然而,检测小的、扁平状或颜色变淡的病变仍然困难。联动彩色成像作为一种新型多光技术,通过在明亮视野中增强早期结直肠肿瘤与周围正常黏膜之间的颜色对比度,便于识别组织中的细微差异。联动彩色成像最显著的特点是能够将早期肿瘤性病变的颜色与炎症变化区分开来,在白光成像下观察时,这两者都有类似的“发红”现象。为提高肿瘤的检出率,内镜观察应从一开始就使用联动彩色成像。早期发现浅表性结直肠肿瘤可降低结直肠癌死亡率,并为患者维持良好的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfa/6453841/e1f5334c4793/ce-2018-189f1.jpg

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