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探索非治愈性内镜黏膜下剥离术:当前治疗优化和未来适应证拓展。

Exploring non-curative endoscopic submucosal dissection: Current treatment optimization and future indication expansion.

机构信息

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.

出版信息

World J Gastroenterol. 2024 Mar 7;30(9):1257-1260. doi: 10.3748/wjg.v30.i9.1257.

Abstract

The increasing popularity of endoscopic submucosal dissection (ESD) as a treatment for early gastric cancer has highlighted the importance of quality assessment in achieving curative resections. This article emphasizes the significance of evaluating ESD quality, not only for curative cases but also for non-curative ones. Postoperative assessment relies on the endoscopic curability (eCura) classification, but management strategies for eCuraC-1 tumour with a positive horizontal margin are unclear. Current research primarily focuses on comparing additional surgical procedures in high-risk patients, while studies specifically targeting eCuraC-1 patients are limited. Exploring management strategies and follow-up outcomes for such cases could provide valuable insights. Furthermore, the application of molecular imaging using near-infrared fluorescent tracers holds promise for precise tumour diagnosis and navigation, potentially impacting the management of early-stage gastric cancer patients. Advancing research in these areas is essential for improving the overall efficacy of endoscopic techniques and refining treatment indications.

摘要

内镜黏膜下剥离术(ESD)作为治疗早期胃癌的一种方法越来越受欢迎,这凸显了在实现治愈性切除的过程中进行质量评估的重要性。本文强调了评估 ESD 质量的重要性,不仅针对治愈性病例,也针对非治愈性病例。术后评估依赖于内镜可切除性(eCura)分类,但对于水平切缘阳性的 eCuraC-1 肿瘤的管理策略尚不清楚。目前的研究主要集中在比较高危患者的额外手术程序,而专门针对 eCuraC-1 患者的研究有限。探索此类病例的管理策略和随访结果可能提供有价值的见解。此外,使用近红外荧光示踪剂的分子成像的应用为精确的肿瘤诊断和导航提供了可能,可能会影响早期胃癌患者的管理。推进这些领域的研究对于提高内镜技术的整体疗效和细化治疗指征至关重要。

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