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首页> 外文期刊>Endoscopy International Open >Endoscopic mucosal resection with anchoring of the snare tip: multicenter retrospective evaluation of effectiveness and safety
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Endoscopic mucosal resection with anchoring of the snare tip: multicenter retrospective evaluation of effectiveness and safety

机译：内镜粘膜切除锚固尖端提示：多中心回顾性评价有效性和安全性

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Background?Endoscopic mucosal resection (EMR) with snare is the recommended technique to resect non-invasive colorectal neoplastic lesions between 10 and 30?mm in diameter. The objective of EMR is to resect completely the neoplastic tissue en bloc and preferably with free margins (R0), avoiding recurrences. Anchoring the tip of the snare in the submucosa is a technical trick that allows snare sliding to be reduced and larger pieces to be caught. The aim of the present study was to evaluate the effectiveness and safety of anchoring-EMR (A-EMR). Methods?This was a retrospective analysis of A-EMR procedures for lesions of diameter between 10 and 30?mm (endoscopic evaluation) performed consecutively in four French centers between May 2017 and January 2018. A-EMR was routinely performed for all EMR using Olympus conventional snares (10 or 25?mm). The primary outcome was evaluation of the proportion of R0 resections. Results?A total of 141 A-EMR procedures were performed by 10 operators. Mean lesion size was 19.8?mm. Anchoring was feasible in 96.5?% of cases. There were 81.6?% en bloc resections and 70.2?% R0 resections, with the percentage of procedures decreasing with increasing lesion size (82.8?% ?20?mm, 55.3?% 21?–?30?mm, and 50.0?% ?30?mm, P?=?0.002). Complete perforations closed endoscopically occurred in 3/141 cases (2.1?%); none occurred in lesions??20?mm in size (0?/87). Conclusion?The A-EMR technique appears to be promising with a high proportion of R0 for lesions of 10?–?20?mm in size without any perforations. It could also offer an alternative to endoscopic submucosal dissection (ESD), or to hybrid techniques to reach R0 for lesions between 20 and 30?mm in size.
机译：背景？内镜粘膜切除（EMR）与圈套是推荐的技术，用于切除直径10至30Ωmm之间的非侵入结直肠肿瘤病变。 EMR的目的是完全切除肿瘤组织EN集团，优选具有自由余量（R0），避免复发。锚定粘膜下的尖端是一种技术技巧，允许陷阱滑动减少和较大的碎片。本研究的目的是评估锚定EMR（A-EMR）的有效性和安全性。方法是对2017年5月至2018年5月至2018年1月间的四个法国中心连续四个法国中心进行的直径的A-EMR程序的回顾性分析。使用OLYMPUS常规地对所有EMR进行了四个法国中心进行了10％至30？mm（内窥镜评估）。常规绞死（10或25Ωmm）。主要结果是评估R0切除术的比例。结果？10个运营商共进行141个A-EMR程序。平均病变大小为19.8？mm。锚定在96.5？％的病例中是可行的。有81.6？％en Bloc切除切除和70.2？％R0切除术，随着病变尺寸的增加（82.8〜20×20≤mm，55.3Ω·20μl，50.0？％，方法百分比>？30？mm，p？= 0.002）。完全穿孔闭合在3/141例中发生内窥镜（2.1？％）;没有发生病变？<？20？mm的大小（0？/ 87）。结论？A-EMR技术似乎具有高比例的R0，病变为10？ - ？20Ωmm，没有任何穿孔。它还可以提供替代的内窥镜粘膜粘膜解剖（ESD），或杂交技术，以达到20至30Ωmm之间的病变的r0。

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