结直肠息肉冷切除术研究进展

Research Progress of Cold Resection of Colorectal Polyps

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.