内镜下粘膜切除术:胃肠道学员的技巧。

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2023-01-01 DOI:10.21037/tgh-23-23
Tessa Herman, Bryant Megna, Kumar Pallav, Mohammad Bilal
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引用次数: 0

摘要

内镜下粘膜切除术(EMR)是一种微创、专门的内镜技术,可用于切除标准息肉切除术无法切除的浅表胃肠道病变。这通常是通过粘膜下注射来完成的,将病变从固有肌层上抬起,允许通过局部或整体切除安全切除息肉。多年来,已有几种EMR技术,包括常规EMR或热EMR、冷EMR和水下EMR。尽管内窥镜切除比手术等传统技术具有既定的优势和安全性,但其采用(以及对胃肠病学受训者的教育和培训)滞后。本文的目的是提供结肠电子病历的基本原则的全面审查。我们回顾了光学诊断的概念,包括各种可用于确定息肉形态和组织学的息肉分类系统。我们还讨论了结肠电子病历的技术方面。我们还概述了与EMR相关的常见不良事件,包括出血,穿孔,息肉切除术后综合征,残余或复发的息肉,并讨论了可以采取的预防措施,以减轻不良事件。最后,我们为希望在临床实践中从事电子病历的学员提供实用提示。
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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Endoscopic mucosal resection: tips and tricks for gastrointestinal trainees.

Endoscopic mucosal resection (EMR) is a minimally invasive, specialized endoscopic technique that is useful in resecting superficial gastrointestinal lesions that are unable to be removed by standard polypectomy. This is typically accomplished using a submucosal injection that lifts the lesion away from the muscularis propria to allow for safe resection of the polyp, either via piecemeal or en bloc resection. Over the years, several techniques exist to perform EMR including conventional EMR or hot EMR, cold EMR and underwater EMR. Despite its established advantages and safety over conventional techniques such as surgery, the adoption of endoscopic resection (and thus the education and training of gastroenterology trainees) is lagging. The goal of this article is to offer a comprehensive review of the basic principles of colonic EMR. We review the concepts of optical diagnosis including the various polyp classification systems available to determine the polyp morphology and histology. We also discuss the technical aspects of performing colonic EMR. We also outline the common adverse events associated with EMR including bleeding, perforation, postpolypectomy syndrome, and residual or recurrent polyps, and discuss preventative measures that can be taken to mitigate adverse events. Lastly, we offer practical tips for trainees who want to undertake EMR in their clinical practice.

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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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