JGH:冷圈套器息肉切除术治疗浅表性非壶腹十二指肠上皮肿瘤安全有效

2022-01-27 MedSci原创 MedSci原创

最近的一项随机研究表明,大小为1-3mm的息肉是冷钳息肉切除术的最佳适应症;可以经1或2次连续活检完全切除。

      尽管浅表性非消化道十二指肠上皮肿瘤(SNADETs)被认为是罕见的疾病,但由于内窥镜技术的进步,SNADETs的确诊病例逐渐增多。因此,内镜下切除SNADETs正在成为一种成熟的手术。但是内镜下的SNADETs切除术,如内镜下的粘膜切除术(EMR)和内窥镜粘膜下剥离术(ESD)的并发症发生率很高,包括穿孔等并发症。

目前,西方国家和日本普遍采用冷阱式息肉切除术(CSP)治疗结直肠息肉。据报道,CSP治疗SNADETs的短期效果很好。然而,CSP治疗SNADETs的长期效果并不完全清楚。因此。本研究旨在评估CSP治疗SNADETs的长期效果。

 

      为了完成本项研究,研究人员回顾性分析了 2015 年 3 月-2018 年 5 月期间在千叶大学医院诊断为散发性 SNADET 并接受 CSP 治疗的患者的临床资料。然后对所有合格患者进行了长期随访并评估了长期结果、短期结果和不良事件的发生差异。

 

      本项研究共纳入 35 名患者,总共46 个病灶。整块切除率为97.8%。37 个病灶(80.4%)被诊断为腺瘤。腺瘤病灶的R0切除率为70.3%。35个腺瘤病灶(94.6%)在CSP完成后超过12个月的随访调查。CSP 后的中位观察期为 48 个月。一名患者在接受仅为 3 个月的随访后死于慢性心力衰竭伴心脏结节病。但是没有患者死于 SNADET。CSP后12个月的无复发生存率为97.1%。CSP 后 12 个月观察到 1 例复发(2.7%),对于这部分患者用 CSP 和冷钳息肉切除术去除了复发病灶。观察期内无新发复发。CSP未发生穿孔或术后出血。

图:冷圈套器息肉切除术镜下照片

 

      本项研究通过长期人口随访发现使用小型 SNADET 的冷圈套器进行息肉切除术是一种安全有效的手术,而且它还具有整块切除率较高和长期局部控制肿瘤复发的能力。

 

 

原始出处:

Kenichiro Okimoto. Et al. Long-term outcomes of cold snare polypectomy for superficial non-ampullary duodenal epithelial tumors. Journal of Gastroenterology and Hepatology.2021.

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    2022-01-29 ms6000000315019678

    都想下载

    0

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