Department of Gastroenterology, Inflammatory Bowel Disease Program, Clinica Universidad de los Andes, Santiago 7620157, RM, Chile.
University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL 60637, United States.
World J Gastroenterol. 2021 May 28;27(20):2521-2530. doi: 10.3748/wjg.v27.i20.2521.
Inflammatory bowel disease, encompassing Crohn's disease (CD) and ulcerative colitis, are chronic immune-mediated inflammatory bowel diseases (IBD) that primarily affect the gastrointestinal tract with periods of activity and remission. Large body of evidence exist to strengthen the prognostic role of endoscopic evaluation for both disease activity and severity and it remains the gold standard for the assessment of mucosal healing. Mucosal healing has been associated with improved clinical outcomes with prolonged remission, decreased hospitalization, IBD-related surgeries and colorectal cancer risk. Therefore, endoscopic objectives in IBD have been incorporated as part of standard care. With the known increased risk of colorectal cancer in IBD, although prevention strategies continue to develop, regular surveillance for early detection of neoplasia continue to be paramount in IBD patients' care. It is thanks to evolving technology and visualization techniques that surveillance strategies are continuously advancing. Therapeutic endoscopic options in IBD have also been expanding, from surgery sparing therapies such as balloon dilation of fibrostenotic strictures in CD to endoscopic mucosal resection of neoplastic lesions. In this review article, we discuss the current evidence on the use of endoscopy as part of standard of care of IBD, its role in surveillance of neoplasia, and the role of interventional endoscopic therapies.
炎症性肠病包括克罗恩病（CD）和溃疡性结肠炎，是慢性免疫介导的炎症性肠病，主要影响胃肠道，有活动期和缓解期。大量证据表明，内镜评估在疾病活动度和严重程度方面具有预后作用，它仍然是评估黏膜愈合的金标准。黏膜愈合与延长缓解期、减少住院治疗、IBD 相关手术和结直肠癌风险的改善临床结局相关。因此，内镜目标已被纳入 IBD 的标准治疗中。由于 IBD 中结直肠癌的风险增加，尽管预防策略不断发展，但在 IBD 患者的护理中，定期进行早期检测肿瘤的监测仍然至关重要。正是由于技术和可视化技术的不断进步，监测策略才得以不断推进。IBD 的治疗性内镜治疗方法也在不断扩大，从 CD 纤维狭窄的球囊扩张等手术保留治疗到肿瘤病变的内镜黏膜切除术。在这篇综述文章中，我们讨论了内镜作为 IBD 标准治疗一部分的应用、在肿瘤监测中的作用以及介入性内镜治疗的作用的现有证据。
