Recent development of optical coherence tomography forpreoperative diagnosis of esophageal malignancies

• 作者: Kaname Uno Tomoyuki Koike Tooru Shimosegawa.
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: DIFFICULT colorectal LESION Complications Endoscopic resection Non-polypoid LESIONS Polypoidlesions RECURRENCE
• 年，卷（期）: 2015,（9）
• 页码范围: 881-888
• 页数: 8页
• 分类号: R

摘要

AIM To assess how many patients with benign ＂difficult＂colorectal lesions （DCRLs） referred to surgical resection,may be treated with endoscopic resection （ER） ratherthan surgical resection.METHODS： The prospectively collected colonoscopydatabase of our Endoscopic Unit was reviewed toidentify all consecutive patients who, between July2011 and August 2013, underwent an endoscopic reevaluationbefore surgical resection due to the presenceof DCRLs with a histological confirmation of benignancyon forceps biopsy. ER was attempted when the lesion did not have definite features of deeply invasivecancer. The ＂nonlifting sign＂ excluded ER only in naivelesions without a prior attempted resection. Lesionswere classified, using the Kyoto-Paris classification formucosal neoplasia. For sessile and non-polypoid lesionsthe ＂inject and cut＂ resection technique was used.Pedunculated and semi-pedunculated lesions weretransected at the stalk just below the polyps head andbefore or after resection, metal clips or a loop wereapplied on the stalk to prevent bleeding. The lesionswere histologically classified according to the Viennacriteria and for the pedunculated lesions the Haggittclassification was used.RESULTS： Eighty-two patients （42 females, meanage 62 years） with 82 lesions （mean size 37 mm）were included in the study. Sixty-nine （84%） lesionswere endoscopically resected, while 13 underwentsurgical resection since ER was deemed unsuitable. Onhistology, cancer was found in 21/69 lesions （14 intramucosal,7 sub-mucosal） and was associated with thesize （P 〈 0.001） and with type 0-Ⅱa ＋Ⅰs （P = 0.011）and 0-Ⅱa ＋ Ⅱc （P 〈 0.001） lesions. All patients withsub-mucosal cancer, underwent surgical resection.Complications occurred in 11/69 patients （7 bleedings,2 transmural burn syndromes, 2 perforations）, allmanaged endoscopically or conservatively, and wereassociated with presence of invasive cancer （P = 0.021）.During follow-up recurrence/residual tissue was foundin 14/5