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大肠广基息肉内镜切除术后复发的防治

Prevention and treatment of recurrence after endoscopic resection of large non-pedunculated colorectal polyps.

作者信息

Pang Samantha, Tavakoli Pedram, Shahidi Neal

机构信息

Department of Gastroenterology, St. Paul's Hospital, Vancouver V6Z2K5, Canada.

Department of Medicine, University of British Columbia, Vancouver V6Z2K5, Canada.

出版信息

World J Gastrointest Endosc. 2025 Jul 16;17(7):107746. doi: 10.4253/wjge.v17.i7.107746.


DOI:10.4253/wjge.v17.i7.107746
PMID:40677574
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12264792/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/c5dcffa6b9c9/wjge-17-7-107746-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/a477814a3948/wjge-17-7-107746-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/5b88118a1a7b/wjge-17-7-107746-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/3847274f223f/wjge-17-7-107746-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/c5dcffa6b9c9/wjge-17-7-107746-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/a477814a3948/wjge-17-7-107746-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/5b88118a1a7b/wjge-17-7-107746-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/3847274f223f/wjge-17-7-107746-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/12264792/c5dcffa6b9c9/wjge-17-7-107746-g004.jpg

相似文献

[1]
Prevention and treatment of recurrence after endoscopic resection of large non-pedunculated colorectal polyps.

World J Gastrointest Endosc. 2025-7-16

[2]
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[4]
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[5]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection.

World J Gastroenterol. 2025-3-21

[2]
Endoscopic submucosal dissection for proximal colonic lesions: An effective therapeutic option.

Endosc Int Open. 2025-1-29

[3]
Endoscopic En Bloc Vs Piecemeal Resection of Large Colonic Adenomas: Carbon Footprint Post Hoc Analysis of a Randomized Trial.

Clin Gastroenterol Hepatol. 2025-3-4

[4]
Margin thermal ablation eliminates size as a risk factor for recurrence after piecemeal endoscopic mucosal resection of large non-pedunculated colorectal polyps.

Gut. 2025-4-7

[5]
Soft Coagulation Versus Argon Plasma Coagulation After Large Non-pedunculated Colorectal Polyp Resection: A Meta-analysis.

J Clin Gastroenterol. 2025-1-15

[6]
Thermal ablation of margins for recurrence prevention after endoscopic mucosal resection: a systematic review and meta-analysis.

Surg Endosc. 2025-2

[7]
Impact of margin thermal ablation after endoscopic mucosal resection of large (≥20 mm) non-pedunculated colonic polyps on long-term recurrence.

Gut. 2024-12-10

[8]
The Recurrence Rate of Colorectal Polyps among Patients with Average Risk of Colorectal Cancer.

Asian Pac J Cancer Prev. 2024-8-1

[9]
Green endoscopy, one step toward a sustainable future: Literature review.

Endosc Int Open. 2024-8-23

[10]
Clinical audit of endoscopic sub-mucosal dissection performed for complex lateral spreading colorectal tumors from a region non-endemic for colorectal cancer.

Indian J Gastroenterol. 2024-10

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