Pathology perspective on endoscopic full thickness resection

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-01-01 DOI:10.1016/j.tgie.2019.03.003

Ladan Fazlollahi MD, Helen E. Remotti MD

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引用次数: 1

Abstract

Recent advances in minimally invasive endoscopic approaches have introduced new resection techniques including the Endoscopic Full Thickness Resection (EFTR) for therapeutic and diagnostic applications. EFTR offers minimally invasive surgery for mucosal or subepithelial lesions that cannot be resected with standard Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection techniques, due to anatomical location or presence of fibrosis (nonlifting epithelial lesions) allowing a safe and effective method to resect the entire gastrointestinal (GI) wall. EFTR is particularly useful for resecting small (<2 cm) subepithelial lesions that arise within the muscular wall that previously required a surgical approach. In addition to therapeutic resections, EFTR biopsies can be diagnostically useful for evaluating a variety of gastrointestinal neuromuscular diseases as well as diagnosing other inflammatory and neoplastic conditions that involve deeper layers of the gut wall. With refinement in resection techniques and increased experience with EFTR, indications for minimally invasive surgery will increase and a standardized pathologic assessment of these specimens will be incorporated into working practice guidelines.

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内镜下全层切除的病理观察

在微创内镜方法的最新进展引入了新的切除技术，包括内镜全层切除(EFTR)的治疗和诊断应用。EFTR为标准内镜下粘膜切除术或内镜下粘膜夹层技术无法切除的粘膜或上皮下病变提供微创手术，由于解剖位置或存在纤维化(非提升上皮病变)，允许安全有效的方法切除整个胃肠道(GI)壁。EFTR特别适用于切除肌肉壁内出现的小的(约2cm)上皮下病变，这些病变以前需要手术切除。除了治疗性切除外，EFTR活检还可用于评估各种胃肠道神经肌肉疾病，以及诊断涉及肠壁深层的其他炎症和肿瘤状况。随着切除技术的改进和EFTR经验的增加，微创手术的适应症将会增加，对这些标本的标准化病理评估将被纳入工作实践指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

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期刊介绍： The purpose of each issue of Techniques in Gastrointestinal Endoscopy is to provide a comprehensive, current overview of a clinical condition or surgical procedure in gastrointestinal endoscopy, combining the effectiveness of an atlas with the timeliness of a journal. Each issue places a vigorous emphasis on diagnosis, rationale for and against a procedure, actual technique, management, and prevention of complications. The journal features abundant illustrations, line drawings and color artwork to guide readers through even the most complicated procedure.