息肉切除术后结肠息肉的检测与监测

O. Laudanno, Betiana Pucci, Santiago Brayer
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引用次数: 0

摘要

结直肠癌是全世界发病率和死亡率的主要原因。预防的基础是筛查平均风险人群(50-75岁,无个人和家族史的无症状人群)和确定高危人群。绝大多数源于癌前息肉(腺瘤、锯齿状病变)。内镜下息肉切除术是降低结直肠癌发病率和死亡率的有效手段。腺瘤检出率是结肠镜检查中最重要的质量指标,与间期癌风险和死亡率呈负相关。在过去的几年中,一些新的技术质量建议和新的设备可用来提高息肉的检测和新的息肉切除术后的监测指南已经出版。基线结肠镜检查的质量和结果将决定监测间隔。另一方面,根据新的流行病学数据,美国最新的指南建议从45岁开始进行结直肠癌筛查。然而,并非所有国家都遵循这一建议。本综述的目的是分析提高腺瘤检出率的技术和设备,新的息肉切除术后监测指南以及开始和停止结直肠癌筛查的年龄。将阿根廷的数据背景化,并讨论相关的正在进行的研究。
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Detección y vigilancia pospolipectomía de pólipos colónicos
Colorectal cancer is a major cause of morbidity and mortality worldwide. Their prevention is based on screening the average risk population (age 50-75, asymptomatic without personal and family history) and the identification of high-risk groups. The vast majority arise from premalignant polyps (adenomas, serrated lesions). Endoscopic polypectomy is effective in reducing colorectal cancer incidence and mortality. The adenoma detection rate is the most important quality measure in colonoscopy and is inversely correlated with the risk of interval cancer and mortality. Over the last years, several new technical-quality recommendations and new devices became available to improve polyp’s detection and new post-polypectomy surveillance guidelines have been published. The quality and findings of the baseline colonoscopy will determine surveillance intervals. On the other hand, the newest guidelines from the United States recommend colorectal cancer screenings begin at the age of 45 based on new epidemiological data. However, not all countries followed this recommendation. The purpose of this review is to analyze techniques and devices to improve the adenoma detection rate, new post-polypectomy surveillance guidelines and the age to start and stop colorectal cancer screening. Contextualize data in Argentina and discuss the relevant ongoing research.
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