混合内镜粘膜下夹层和内镜全层切除术在T1结肠腺癌R0切除术中的应用

Q3 Medicine

VideoGIE Pub Date : 2025-03-21 DOI:10.1016/j.vgie.2025.03.026

Rahul Karna MD , Iman Afraz MBBS , Juan C. Manivel MD , Daniela Guerrero Vinsard MD , Mohammad Bilal MD

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引用次数: 0

摘要

背景与目的局限于浅表粘膜下层的恶性结肠息肉可以通过内镜切除作为一种治疗策略。内镜下全层切除（EFTR）可以对恶性息肉进行整体切除；然而，对于粘膜下浸润或20mm大小的病变，该技术具有挑战性。方法本文综述了内镜下粘膜下剥离（ESD）和EFTR混合技术在T1结肠腺癌R0切除术中的应用。结果在病例中，采用静电放电使35 mm的病变柔韧。该步骤允许病变被拉入帽内，并使用全层切除装置完成整体切除。结论该病例强调了混合静电放电- eftr技术是可行的，可以对病灶大小为20mm的浅表浸润性粘膜下结肠腺癌进行整体切除。初始的粘膜切口和部分的粘膜下剥离可以使具有潜在粘膜下浸润的病变柔韧，因此可以使用全层切除装置进行全层切除。

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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Hybrid endoscopic submucosal dissection and endoscopic full-thickness resection for R0 resection of T1 colonic adenocarcinoma

Background and Aims

Malignant colorectal polyps limited to superficial submucosa can undergo endoscopic resection as a curative strategy. Endoscopic full-thickness resection (EFTR) allows en bloc resection of malignant polyps; however, the technique is challenging in lesions with submucosal invasion or those >20 mm in size.

Methods

This original article and accompanying video reviews the technique for hybrid endoscopic submucosal dissection (ESD) and EFTR to allow R0 resection of T1 colonic adenocarcinoma.

Results

In the case example, ESD was performed to make a 35-mm lesion pliable. This step allowed the lesion to be pulled into the cap and complete en bloc resection using the full-thickness resection device.

Conclusions

The case highlights that hybrid ESD-EFTR technique is feasible and allows for en bloc removal of superficially invasive submucosal colon adenocarcinoma with lesions >20 mm in size. Initial mucosal incision and partial submucosal dissection can make the lesions with underlying submucosal invasion pliable and hence amenable to full-thickness resection using a full-thickness resection device.

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.