巨大结肠息肉的内窥镜治疗:一项意大利回顾性研究

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
P. Quitadamo, Sara Isoldi, G. de Nucci, Giulia Muzi, Flora Caruso
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引用次数: 0

摘要

背景/目的:大于 30 毫米的息肉被归类为 "巨型息肉"。内窥镜下切除息肉是一项技术挑战。选择内窥镜切除技术非常重要,因为它能为精确的组织病理学分期提供切除样本。这对诊断、预后和管理至关重要。方法:通过回顾性分析,我们获得了 38 个巨大息肉样本。其中 18 例息肉切除术采用了肾上腺素体积缩小法(EVR),9 例息肉切除术采用了内环切法或剪切法,11 例患者接受了手术治疗。结果:我们在所有病例中都采用了EVR方法进行了全切;组织学检查证实了所有病例中内镜切除术的正确适应症。此外,没有发现早期或延迟并发症,也没有患者需要住院治疗。在采用内镜下环切或剪切方法的病例中,我们观察到1/9(11.1%)的病例组织学结果为晚期,另一名患者(1/9,11.1%)出现延迟出血。在接受手术的患者中,5/11(45.5%)例被认为治疗过度,3 例出现术后并发症。结论:我们建议将 EVR 作为巨型息肉切除术的替代技术,因为它安全、有效、经济,而且可以避免推迟息肉切除术的时间。进一步的前瞻性研究可能有助于改善这一经验并提高技术水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic management of giant colonic polyps: a retrospective Italian study
Background/Aims: Polyps greater than 30 mm are classified as “giants”. Their endoscopic removal represents a technical challenge. The choice of the endoscopic removal technique is important because it provides a resection sample for precise histopathological staging. This is pivotal for diagnostic, prognostic, and management purposes. Methods: From a retrospective analysis, we obtained a sample of 38 giant polyps. Eighteen polypectomies were performed using the epinephrine volume reduction (EVR) method, nine polypectomies utilized endo-looping or clipping methods, and 11 patients underwent surgery. Results: We obtained en bloc resection with the EVR method in all cases; histology confirmed the correct indication for endoscopic resection in all cases. Moreover, no early or delayed complications were observed, and no patient required hospitalization. Using en-do-looping or clipping methods, we observed advanced histology in 1/9 (11.1%) cases, while another patient (1/9, 11.1%) had delayed bleeding. Among patients who underwent surgery, 5/11 (45.5%) were deemed overtreated and three had post-surgical complications. Conclusions: We propose EVR as an alternative technique for giant polyp resection due to its safety, effectiveness, cost-efficiency, and the advantage of avoiding the need to postpone polypectomy to a later time. Further prospective studies might help improve this experience and enhance the technique.
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
期刊介绍: ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.
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