Queen Alexandra Hospital, Portsmouth, UK.
Dig Endosc. 2020 May;32(4):503-511. doi: 10.1111/den.13475. Epub 2019 Aug 8.
Endoscopic treatment of colorectal lesions has seen major developments in the last decade. It is now considered curative for intramucosal and superficial submucosal cancers. Endoscopic Mucosal Resection in expert hands has very good outcomes with low complication rates but recurrence and inadequate treatment of early cancers remain an issue. This has led to a technical evolution that can lead to one piece resection of neoplasia. This includes a range of techniques from knife assisted snare resection (KAR), endoscopic submucosal dissection (ESD) to full thickness resections. This article reviews all the resection techniques and the evidence base behind them.
在过去的十年中,结直肠病变的内镜治疗取得了重大进展。目前,它被认为是黏膜内和浅层黏膜下癌症的一种治愈方法。在专家手中,内镜黏膜切除术(EMR)具有非常好的结果,并发症发生率低,但早期癌症的复发和治疗不足仍然是一个问题。这导致了一种技术上的发展,可以实现肿瘤的整块切除。这包括一系列技术,从刀辅助套扎切除术(KAR)、内镜黏膜下剥离术(ESD)到全层切除术。本文综述了所有的切除技术及其背后的证据基础。