Pang Samantha, Tavakoli Pedram, Shahidi Neal
Department of Gastroenterology, St. Paul's Hospital, Vancouver V6Z2K5, Canada.
Department of Medicine, University of British Columbia, Vancouver V6Z2K5, Canada.
World J Gastrointest Endosc. 2025 Jul 16;17(7):107746. doi: 10.4253/wjge.v17.i7.107746.
Minimally invasive endoscopic resection techniques are the recommended first-line treatment strategy for the majority of large non-pedunculated colorectal polyps, with endoscopic mucosal resection (EMR) as a predominant resection modality due to its efficacy, efficiency, safety, and cost-effectiveness. A limitation of EMR is recurrence, which has historically occurred in 15%-20% of lesions. In the past 10 years, a number of effective mitigating strategies have been developed, including margin thermal ablation using snare-tip soft coagulation, argon plasma coagulation (APC), and hybrid-APC, alongside margin marking pre-resection. Moreover, techniques for effective recurrence management have also been developed. Herein, we appraise existing evidence on the frequency of recurrence, reasonings behind recurrence formation, as well as recurrence mitigating strategies and the effectiveness of recurrence management.
微创内镜切除技术是大多数大型无蒂结直肠息肉推荐的一线治疗策略,内镜黏膜切除术(EMR)因其有效性、高效性、安全性和成本效益而成为主要的切除方式。EMR的一个局限性是复发,历史上15%-20%的病变会出现复发。在过去10年里,已经开发了一些有效的缓解策略,包括使用圈套器尖端软凝、氩等离子体凝固(APC)和混合APC进行边缘热消融,以及术前边缘标记。此外,还开发了有效的复发管理技术。在此,我们评估了关于复发频率、复发形成原因、复发缓解策略以及复发管理有效性的现有证据。
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