O'Sullivan Timothy, Bourke Michael J
Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, Australia.
University of Sydney, Westmead Clinical School, Westmead, NSW, Australia.
Visc Med. 2024 Aug;40(4):217-227. doi: 10.1159/000539219. Epub 2024 Jun 26.
Colorectal cancer is a highly prevalent malignancy and a significant driver of cancer mortality and health-related expenditure worldwide. Polyp removal reduces the incidence and mortality of colorectal cancer. In 2024, endoscopists have an array of resection modalities at their disposal. Each technique requires a unique skillset and has individual advantages and limitations. Consequently, resection in the colorectum requires an evidence-based algorithm approach that considers these factors.
A literature review of endoscopic resection for colonic neoplasia was conducted. Best supporting scientific evidence was summarized for the endoscopic resection of diminutive polyps, large ≥20 mm lesions and polyps containing invasive cancer. Factors including resection modality, complications and lesion selection were explored to inform an algorithm approach to colorectal resection.
Endoscopic resection in the colorectum is not a one-size-fits-all approach. Detailed understanding of polyp size, location, morphology and predicted histology are critical factors that inform appropriate endoscopic resection practice.
结直肠癌是一种高度常见的恶性肿瘤，是全球癌症死亡率和健康相关支出的重要驱动因素。息肉切除可降低结直肠癌的发病率和死亡率。2024年，内镜医师可采用一系列切除方式。每种技术都需要独特的技能组合，且有各自的优缺点。因此，结直肠切除需要一种基于证据的算法方法来考虑这些因素。
对结肠肿瘤的内镜切除进行了文献综述。总结了支持内镜切除微小息肉、≥20毫米的大病变以及含有浸润性癌的息肉的最佳科学证据。探讨了包括切除方式、并发症和病变选择等因素，以为结直肠切除的算法方法提供参考。
结直肠的内镜切除并非适用于所有情况的方法。对息肉大小、位置、形态和预测组织学的详细了解是指导适当内镜切除实践的关键因素。
