早期胃癌内镜切除术后对并发胃病变的最佳监控

IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Gut and Liver Pub Date : 2024-09-15 Epub Date: 2024-08-08 DOI:10.5009/gnl240027
Dong Chan Joo, Gwang Ha Kim
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引用次数: 0

摘要

内镜下胃癌切除术(ER)是一种微创手术,与外科胃切除术相比,ER具有保留整个胃部和维持患者生活质量的优点,是治疗早期胃癌(EGC)的一种广泛应用的根治性疗法。尽管这种治疗方法具有保留全胃等优点,但胃切除术后仍有大面积胃黏膜发生萎缩和肠化生等组织学改变,而且还存在发生隐匿性胃癌(MGC)的风险。因此,EGC治愈性ER后定期进行监测内镜检查非常重要,这样才能及早发现MGC,使微创ER成为一种治疗选择。迄今为止,EGCs根治性ER术后监测内镜检查的最佳间隔时间尚未确定。因此,本综述总结了已发表的相关研究结果,旨在确定早期识别 MGCs 的最佳监测时间间隔。根据我的综述,MGC 发生的中位时间为 3 年内,有报告建议在最初 3 年内每半年进行一次内镜检查;但是,有证据表明,患者的个体特征可能会影响 MGC 的风险。因此,应根据患者的特征,如年龄、胃癌家族史、同步性胃病变和肠套叠等,采取分层内镜监测策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimal Surveillance of Metachronous Gastric Lesion after Endoscopic Resection of Early Gastric Cancer.

Endoscopic resection (ER)-a minimal invasive procedure, compared to surgical gastrectomy, with the advantage of preserving the entire stomach and maintaining the patient's quality of life-is a widely used curative treatment for early gastric cancers (EGCs). Despite its advantages, such as the preservation of the whole stomach, a large area of the gastric mucosa with histologic changes such as atrophy and intestinal metaplasia remains after ER, and so does the risk of metachronous gastric cancers (MGCs). Therefore, regular surveillance endoscopy after curative ER of EGCs is important so that MGCs are detected early and so minimally invasive ER remains a treatment option. To date, the optimal interval for surveillance endoscopy after curative ER of EGCs has not been established. Therefore, this review summarizes the results of the published studies on this topic with the aim of establishing the optimal surveillance interval for early identification of MGCs. Based on my review, the median timing of MGC occurrence is within 3 years, and reports suggest biannual endoscopy during the first 3 years; however, the evidence suggests that individual patient characteristics may influence the risk of MGCs. Therefore, stratified endoscopic strategies for surveillance based on patient characteristics, such as age, family history of gastric cancer, synchronous gastric lesions, and corpus intestinal metaplasia, should be applied.

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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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