Miao Yan-Dong, Tang Xiao-Long, Wang Jiang-Tao, Mi Deng-Hai
The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China.
World J Gastrointest Oncol. 2022 Feb 15;14(2):543-546. doi: 10.4251/wjgo.v14.i2.543.
Endoscopic ectomy of large nonpedunculated colorectal lesions (≥ 20 mm) might cause significant adverse incidents, such as delayed perforation and delayed bleeding, despite the closure of mucosal lesions with clips. The conventional utilization of prophylactic clipping has not decreased the risk of postprocedural delayed adverse events, and additional outcomes and cost-effectiveness research is needed for patients with proximal lesions ≥ 20 mm, in whom prophylactic clipping might be useful. Coverage of the wound after endoscopic excision offers shield protection against delayed concomitant diseases.
对于直径≥20mm的大肠广基病变进行内镜下切除术,即便使用夹子封闭黏膜病变,仍可能引发严重不良事件,如延迟穿孔和延迟出血。预防性夹闭的常规应用并未降低术后延迟不良事件的风险,对于近端≥20mm的病变患者,可能需要进行额外的疗效及成本效益研究,因为预防性夹闭可能对这类患者有用。内镜切除术后伤口覆盖可为预防延迟性伴发疾病提供屏障保护。