From the Department of Medicine, University of British Columbia, Vancouver, BC (Jiang, Shahidi); St. Paul's Hospital, Division of Gastroenterology, Vancouver, BC (Shahidi).
From the Department of Medicine, University of British Columbia, Vancouver, BC (Jiang, Shahidi); St. Paul's Hospital, Division of Gastroenterology, Vancouver, BC (Shahidi)
Can J Surg. 2024 Oct 23;67(5):E345-E348. doi: 10.1503/cjs.010623. Print 2024 Sep-Oct.
SummaryMinimally invasive endoscopic resection techniques are now the first-line management strategy for most large (> 20 mm) nonpedunculated colorectal polyps (LNPCPs). Appropriate technique selection depends on optical evaluation to predict lesion histopathology alongside the presence of and depth of malignant invasion. We review the indications and performance of endoscopic mucosal resection, cold snare resection, and endoscopic submucosal dissection. These complementary techniques, bolstered by site-specific technical modifications and ancillary techniques, are an effective, efficient, and safe alternative to surgery. An understanding of the role of minimally invasive endoscopic resection techniques is crucial for all endoscopists and surgeons involved in LNPCP management.
对于大多数（> 20 毫米）大型无蒂结直肠息肉（LNPCP），微创内镜下切除术现已成为一线治疗策略。合适的技术选择取决于光学评估，以预测病变的组织病理学特征，以及恶性侵犯的存在和深度。我们回顾了内镜黏膜切除术、冷圈套切除术和内镜黏膜下剥离术的适应证和性能。这些相辅相成的技术，通过特定部位的技术改良和辅助技术得到加强，是手术的有效、高效和安全替代方法。所有参与 LNPCP 管理的内镜医生和外科医生都必须了解微创内镜下切除术的作用。
