Colonoscopy is a risk factor for colon ischemia.The colon is susceptible to ischemia due to its minor blood flow compared to other abdominal organs;the etiology of colon ischemia after colonoscopy is multifactorial.Th...Colonoscopy is a risk factor for colon ischemia.The colon is susceptible to ischemia due to its minor blood flow compared to other abdominal organs;the etiology of colon ischemia after colonoscopy is multifactorial.The causative mechanisms include splanchnic circulation impairment,bowel preparation,drugs used for sedation,bowel wall ischemia due to insufflation/barotrauma,and introduction of the endoscope.Gastroenterologists must be aware of this condition and its risk factors for risk minimization,early diagnosis,and proper treatment.展开更多
Rectal neuroendocrine neoplasia(rNEN)are usually small(<10mm),well-differentiated(G1/2)lesions arising from the interface between mucosal and submucosal layers;therefore,polypectomy and standard endoscopic mucosal ...Rectal neuroendocrine neoplasia(rNEN)are usually small(<10mm),well-differentiated(G1/2)lesions arising from the interface between mucosal and submucosal layers;therefore,polypectomy and standard endoscopic mucosal resection(EMR)techniques are usually not curative due to the presence of neoplastic cells on the resection margin,leading to possible tumor recurrence[1].Ligation-assisted EMR and endoscopic submucosal dissection(ESD)have been proposed as treatment of choice in case of lesions<10mm without muscolaris propria involvement[1-3].However,in real practice,most of these lesions undergo standard EMR and are then refereed to tertiary centers in case of incomplete resections[2,3].Pagano et al.[4]recently demonstrated that,in those cases,ESD was indicated for lesions>3mm because of the risk of residual neoplasia.展开更多
文摘Colonoscopy is a risk factor for colon ischemia.The colon is susceptible to ischemia due to its minor blood flow compared to other abdominal organs;the etiology of colon ischemia after colonoscopy is multifactorial.The causative mechanisms include splanchnic circulation impairment,bowel preparation,drugs used for sedation,bowel wall ischemia due to insufflation/barotrauma,and introduction of the endoscope.Gastroenterologists must be aware of this condition and its risk factors for risk minimization,early diagnosis,and proper treatment.
文摘Rectal neuroendocrine neoplasia(rNEN)are usually small(<10mm),well-differentiated(G1/2)lesions arising from the interface between mucosal and submucosal layers;therefore,polypectomy and standard endoscopic mucosal resection(EMR)techniques are usually not curative due to the presence of neoplastic cells on the resection margin,leading to possible tumor recurrence[1].Ligation-assisted EMR and endoscopic submucosal dissection(ESD)have been proposed as treatment of choice in case of lesions<10mm without muscolaris propria involvement[1-3].However,in real practice,most of these lesions undergo standard EMR and are then refereed to tertiary centers in case of incomplete resections[2,3].Pagano et al.[4]recently demonstrated that,in those cases,ESD was indicated for lesions>3mm because of the risk of residual neoplasia.
