|
|
结直肠息肉冷切除术研究进展
|
Abstract:
结直肠息肉是常见的消化系统疾病，是结直肠癌癌前病变，结直肠癌作为全球危害性的消化系统癌症，其早期诊断和治疗方法至关重要，因此，早期结肠镜下切除结直肠息肉可以降低结直肠癌发病率，能够显著减少结直肠癌的患者数量。冷圈套器息肉切除术(Cold snare polypectomy, CSP)在欧洲及日本得到了普遍应用，尤其是在(微)小结直肠息肉的诊断和治疗上，且最新欧洲胃肠镜学会(ESGE)指南明确指出1~9 mm结直肠(微)小息肉采用冷圈套息肉切除术，不仅安全而且有效。在美国指南当中对于10~19 mm无蒂息肉，建议使用圈套器息肉冷切或电切除术(有或无黏膜下注射)。未明确指出用冷切除术。显然，在未来，冷切技术将成为内镜下息肉切除手术的主流方法。
Colorectal polyps are common digestive system diseases and precancerous lesions of colorectal cancer. As a globally harmful digestive system cancer, early diagnosis and treatment of colorectal cancer are very important. Therefore, early resection of colorectal polyps under colonoscopy can reduce the incidence rate of colorectal cancer and significantly reduce the number of patients with colorectal cancer. Cold snare polypectomy (CSP) has been widely used in Europe and Japan, espe-cially in the diagnosis and treatment of (micro) colorectal polyps. The latest European Society of Gastroenteroscopy (ESGE) guidelines clearly state that cold snare polypectomy is not only safe but also effective for 1~9 mm colorectal (micro) polyps. In the guidelines of the United States, it is rec-ommended to use a snare device for cold polypectomy or electrical resection (with or without sub-mucosal injection) of 10~19 mm sessile polyps. The use of cold resection was not explicitly indicated. Obviously, in the future, cold resection technology will become the mainstream method for endo-scopic polypectomy surgery.
| [1] | Lis, K. and Martin, A. (2016) Mismatch Repair and Colon Cancer: Mechanisms and Therapies Explored. Trends in Mo-lecular Medicine, 22, 274-289. https://doi.org/10.1016/j.molmed.2016.02.003 |
| [2] | 陈万青, 李霓, 兰平, 等. 中国结直肠癌筛查与早诊早治指南(2020, 北京) [J]. 中国肿瘤, 2021, 30(1): 1-28. |
| [3] | DeSantis, C.E., Lin, C.C., Mariotto, A.B., et al. (2014) Cancer Treatment and Survivorship Statistics, 2014. CA: A Cancer Journal for Clinicians, 64, 252-271. https://doi.org/10.3322/caac.21235 |
| [4] | 国家消化系统疾病临床医学研究中心(上海), 国家消化道早癌防治中心联盟, 中华医学会消化内镜学分会, 等. 中国早期结直肠癌筛查流程专家共识意见(2019, 上海) [J]. 中华消化内镜杂志, 2019, 36(10): 709-719. |
| [5] | Li, J., Ma, X., Chakravarti, D., Shalapour, S. and DePinho, R.A. (2021) Genetic and Biological Hallmarks of Colorectal Cancer. Genes & Development, 35, 787-820. https://doi.org/10.1101/gad.348226.120 |
| [6] | Adachi, M., Ryan, P., Collopy, B., et al. (1991) Adenoma-Carcinoma Sequence of the Large Bowel. ANZ Journal of Surgery, 61, 409-414. https://doi.org/10.1111/j.1445-2197.1991.tb00252.x |
| [7] | Kaminski, M.F., Robertson, D.J., Senore, C. and Rex, D.K. (2020) Optimizing the Quality of Colorectal Cancer Screening Worldwide. Gastroenterology, 158, 404-417. https://doi.org/10.1053/j.gastro.2019.11.026 |
| [8] | Zauber, A.G., Winawer, S.J., O’Brien, M.J., et al. (2012) Co-lonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths. The New England Journal of Medicine, 366, 687-696.
https://doi.org/10.1056/NEJMoa1100370 |
| [9] | 段志英, 王鹏羽, 韩双双, 等. 冷圈套治疗结直肠小息肉应用价值的Meta分析[J]. 中华消化内镜杂志, 2015, 32(12): 832-836. |
| [10] | Fyock, C.J. and Draganov, P.V. (2010) Colon-oscopic Polypectomy and Associated Techniques. World Journal of Gastroenterology, 16, 3630-3637. https://doi.org/10.3748/wjg.v16.i29.3630 |
| [11] | 谢娇, 王雯. 结直肠息肉冷切除术相关研究进展[J]. 中华胃肠内镜电子杂志, 2018, 5(4): 158-162. |
| [12] | 莫双阳, 蔡怀阳, 王迎伟, 等. 结直肠息肉内镜下圈套器冷切除的临床疗效与安全性[J]. 现代消化及介入诊疗, 2021, 26(11): 1449-1452. |
| [13] | Horiuchi, A., Nakayama, Y., Kajiyama, M., et al. (2014) Removal of Small Colorectal Polyps in Anticoagulated Patients: A Prospective Randomized Comparison of Cold Snare and Conventional Polypectomy. Gastrointestinal Endoscopy, 79, 417-423. https://doi.org/10.1016/j.gie.2013.08.040 |
| [14] | Singh, N., Harrison, M. and Rex, D.K. (2004) A Survey of Colon-oscopic Polypectomy Practices among Clinical Gastroenterologists. Gastrointestinal Endoscopy, 60, 414-418. https://doi.org/10.1016/S0016-5107(04)01808-5 |
| [15] | Repici, A., Hassan, C., Vitetta, E., et al. (2012) Safety of Cold Polypectomy for < 10 mm Polyps at Colonoscopy: A Prospective Multicenter Study. Endoscopy, 44, 27-31. https://doi.org/10.1055/s-0031-1291387 |
| [16] | Choksi, N., Elmunzer, B.J., Stidham, R.W., et al. (2015) Cold Snare Piecemeal Resection of Colonic and Duodenal Polyps ≥ 1 cm. Endoscopy International Open, 3, E508-E513. https://doi.org/10.1055/s-0034-1392214 |
| [17] | Ma, X., Feng, X., Li, Y., et al. (2022) A Comparison of Incomplete Resection Rate of Large and Small Colorectal Polyps by Cold Snare Polypectomy. Clinical Gastroenterology and Hepa-tology, 20, 1163-1170.
https://doi.org/10.1016/j.cgh.2021.11.010 |
| [18] | Deenadayalu, V.P. and Rex, D.K. (2005) Colon Polyps Retrieval after Cold Snaring. Gastrointestinal Endoscopy, 62, 253-256. https://doi.org/10.1016/S0016-5107(05)00376-7 |
| [19] | Rex, D.K. (2009) Narrow-Band Imaging without Optical Magnification for Histologic Analysis of Colorectal Polyps. Gastroenterology, 136, 1174-1181. https://doi.org/10.1053/j.gastro.2008.12.009 |
| [20] | Efthymiou, M., Taylor, A.C., Desmond, P.V., et al. (2011) Bi-opsy Forceps Is Inadequate for the Resection of Diminutive Polyps. Endoscopy, 43, 312-316. https://doi.org/10.1055/s-0030-1256086 |
| [21] | Lee, C.K., Shim, J.J. and Jang, J.Y. (2013) Cold Snare Polypectomy vs. Cold Forceps Polypectomy Using Double- Biopsy Technique for Removal of I Diminutive Colorectal Polyps: A Prospective Randomized Study. American Journal of Gastroenterology, 108, 1593-1600. https://doi.org/10.1038/ajg.2013.302 |
| [22] | 朱晓佳. 冷圈套内镜黏膜切除术治疗6~15 mm无蒂结直肠息肉的临床分析[D]: [硕士学位论文]. 南昌: 南昌大学, 2021. https://doi.org/10.27232/d.cnki.gnchu.2021.000153 |
| [23] | Kawamura, T., Takeuchi, Y., Yokota, L., et al. (2020) In-dications for Cold Polypectomy Stratified by the Colorectal Polyps Size: A Systematic Review and Meta-Analysis. Journal of the Anus, Rectum and Colon, 4, 67-78.
https://doi.org/10.23922/jarc.2019-039 |
| [24] | Shinozaki, S., Kobayashi, Y., Hayashi, Y., et al. (2018) Efficacy and Safety of Cold versus Hot Snare Polypectomy for Resecting Small Colorectal Polyps: Systematic Review and Me-ta-Analysis. Digestive Endoscopy, 30, 592-599.
https://doi.org/10.1111/den.13173 |
| [25] | Fujiya, M., Sato, H., Ueno, N., et al. (2016) Efficacy and Adverse Events of Cold vs Hot Polypectomy: A Meta-Analysis. World Journal of Gastroenterology, 22, 5436-5444. https://doi.org/10.3748/wjg.v22.i23.5436 |
| [26] | Zhang, Q., Gao, P., Han, B., et al. (2018) Polypectorny for Com-plete Endoscopic Resection of Small Colorectal Polyps. Gastrointestinal Endoscopy, 87, 733-740. https://doi.org/10.1016/j.gie.2017.06.010 |
| [27] | Ito, A., Suga, T., Ota, H., et al. (2018) Resection Depth and Layer of Cold Snare Polypectomy versus Endoscopic Mucosal Resection. Journal of Gastroenterology, 53, 1171-1178. https://doi.org/10.1007/s00535-018-1446-2 |
| [28] | Papastergiou, V., Paraskeva, K.D., Fragaki, M., et al. (2018) Cold versus Hot Endoscopic Mucosal Resection for Nonpedunculated Colorectal Polyps Sized 6-10 mm: A Randomized Trial. Endoscopy, 50, 403-411.
https://doi.org/10.1055/s-0043-118594 |
| [29] | Hewett, D.G. and Tutticci, N.J. (2018) Cold Snare Polypectomy: Is There a Limit to Polyps Size. Endoscopy, 50, 356-357. https://doi.org/10.1055/a-0576-0461 |
| [30] | Thoguluva, C.V., Spadaccini, M., Aziz, M., et al. (2019) Cold Snare Endoscopic Resection of Nonpedunculated Colorectal Polyps Larger than 10 mm: A Systematic Review and Pooled-Analysis. Gastrointestinal Endoscopy, 89, 929-936.
https://doi.org/10.1016/j.gie.2018.12.022 |
| [31] | Kawamura, T., Takeuchi, Y., Asai, S., et al. (2018) A Comparison of the Resection Rate for Cold and Hot Snare Polypectomy for 4-9 mm Colorectal Polyps: A Multicentre Randomised Controlled Trial (CRESCENT Study). Gut, 67, 1950-1957. https://doi.org/10.1136/gutjnl-2017-314215 |
| [32] | Yamashina, T., Fukuhara, M., Maruo, T., et al. (2017) Cold Snare Polypectomy Reduced Delayed Postpolypectomy Bleeding Compared with Conventional Hot Polypectomy: A Propensity Score-Matching Analysis. Endoscopy International Open, 5, E587-E594. https://doi.org/10.1055/s-0043-105578 |
| [33] | Ichise, Y., Horiuchi, A., Nakayama, Y. and Tanaka, N. (2011) Pro-spective Randomized Comparison of Cold Snare Polypectomy and Conventional Polypectomy for Small Colorectal Polyps. Digestion, 84, 78-81.
https://doi.org/10.1159/000323959 |
| [34] | PasPatis, G.A., Tribonias, G., Konstantinidis, K., et al. (2011) A Prospec-tive Randomized Comparison of Cold vs Hot Snare Polypectomy in the Occurrence of Postpolypectomy Bleeding in Small Colonic Polyps. Colorectal Disease, 13, e345-e348. https://doi.org/10.1111/j.1463-1318.2011.02696.x |
| [35] | Komeda, Y., Suzuki, N., Sarah, M., et al. (2013) Factors Associated with Failed Polyps Retrieval at Screening Colonoscopy. Gastrointestinal Endoscopy, 77, 395-400. https://doi.org/10.1016/j.gie.2012.10.007 |
| [36] | Takeuchi, Y., Yamashina, T., Matsuura, N., et al. (2015) Feasibility of Cold Snare Polypectomy in Japan: A Pilot Study. World Journal of Gastrointestinal Endoscopy, 7, 1250-1256. https://doi.org/10.4253/wjge.v7.i17.1250 |
| [37] | Shinozaki, S., Kobayashi, Y., Hayashi, Y., Sakamoto, H., Lefor, A.K. and Yamamoto, H. (2018) Efficacy and Safety of Cold versus Hot Snare Polypectomy for Resecting Small Colo-rectal Polyps: Systematic Review and Meta-Analysis. Digestive Endoscopy, 30, 592-599. https://doi.org/10.1111/den.13173 |
| [38] | Gomez, V., Badillo, R.J., Crook, J.E., Krishna, M., Diehl, N.N. and Wal-lace, M.B. (2015) Diminutive Colorectal Polyps Resection Comparing Hot and Cold Snare and Cold Biopsy Forceps Polypectomy. Results of a Pilot Randomized, Single-Center Study (with Videos). Endoscopy International Open, 3, E76-E80.
https://doi.org/10.1055/s-0034-1390789 |
| [39] | Suzuki, S., Gotoda, T., Kusano, C., et al. (2018) Width and Depth of Resection for Small Colorectal Polyps: Hot versus Cold Snare Polypectomy. Gastrointestinal Endoscopy, 87, 1095-1103. https://doi.org/10.1016/j.gie.2017.10.041 |
| [40] | Makino, T., Horiuchi, A., Kajiyama, M., Tanaka, N., Sano, K. and Maetani, I. (2018) Delayed Bleeding Following Cold Snare Polypectomy for Small Colorectal Polyps in Patients Taking Antithrombotic Agents. Journal of Clinical Gastroenterology, 52, 502-507. https://doi.org/10.1097/MCG.0000000000000802 |
| [41] | Takayanagi, D., Nemoto, D., Isohata, N., et al. (2018) Histological Comparison of Cold versus Hot Snare Resections of the Colorectal Mucosa. Diseases of the Colon & Rec-tum, 61, 964-970.
https://doi.org/10.1097/DCR.0000000000001109 |
| [42] | Piraka, C., Saeed, A., Waljee, A.K., Pillai, A., Stidham, R. and Elmunzer, B.J. (2017) Cold Snare Polypectomy for Non-Pedunculated Colon Polyps Greater than 1？ cm. Endoscopy International Open, 5, E184-E189.
https://doi.org/10.1055/s-0043-101696 |
| [43] | Tate, D.J., Awadie, H., Bahin, F.F., et al. (2018) Wide-Field Piecemeal Cold Snare Polypectomy of Large Sessile Serrated Polyps without Submucosal Injection Is Safe. Endoscopy, 50, 248-252. https://doi.org/10.1055/s-0043-121219 |
| [44] | Tutticci, N. and Hewett, D.G. (2018) Cold EMR of Large Sessile Serrated Polyps at Colonoscopy (with Video). Gastrointestinal Endoscopy, 87, 837-842. https://doi.org/10.1016/j.gie.2017.11.002 |
