Tutticci Nicholas J, Kheir Ammar O, Hewett David G
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Brisbane, Queensland 4108, Australia; Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Brisbane, Queensland 4108, Australia; Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE. Electronic address: https://twitter.com/ammarkheir.
Gastrointest Endosc Clin N Am. 2019 Oct;29(4):721-736. doi: 10.1016/j.giec.2019.06.003. Epub 2019 Jul 26.
Cold resection for small colonic polyps, and larger lesions, is being rapidly and widely adopted. Driven by an impressive safety and cost profile compared with conventional polypectomy, these advantages are offset by the limitations of smaller and shallower resection, and absent thermal effects that may permit persistence of residual neoplasia. To overcome this, optimal cold snare technique requires inclusion of a margin of normal mucosa and a piecemeal resection technique for larger polyps. This article examines the fundamentals of cold snare resection and evidence for its application, theorizes on limits to its application, and identifies areas for further research.
小的结肠息肉以及较大病变的冷切除术正在迅速且广泛地被采用。与传统息肉切除术相比，因其令人印象深刻的安全性和成本效益而受到推动，但这些优势被切除范围较小且较浅以及缺乏可能使残留肿瘤持续存在的热效应所抵消。为克服这一问题，最佳的冷圈套技术需要包含正常黏膜边缘以及对较大息肉采用分块切除技术。本文探讨了冷圈套切除术的基本原理及其应用证据，对其应用的局限性进行了理论分析，并确定了进一步研究的领域。
