结直肠微小息肉和小息肉治疗新决策

New treatment decision of diminutive and small colorectal polyps

结肠镜检查发现的结直肠息肉以微小息肉(≤5 mm)或小息肉(6~9 mm)最为常见。其中只有0.3%~5%的微小息肉和小息肉存在高度异型增生或发展为癌症,形成和发展至进展期组织学的潜力很低。传统的指导方针建议去除所有息肉。但常规去除所有息肉将导致结肠镜检查负担增大。国内关于结直肠微小息肉和小息肉的自然病程、术后特点和随访结果研究非常少,且对是否需要内镜治疗存在争议。

The most commonly detected polyps during screening colonoscopy are diminutive （≤5 mm） and small polyps （6–9 mm）, in which only 0.3%–5% small or diminutive polyps may have harbour high-grade dysplasia or cancer. The potential to grow and develop advanced adenoma is low. Traditional guidelines still recommend the removal of all polyps. But routine removal of these polyps results in a significant burden to colonoscopy programs. In China, there are few studies on the natural history, postoperative characteristics, and follow-up results, and whether endoscopic treatment is needed is controversial.