Polypectomy of colonic polyps has been shown to reduce the risk of colon cancer development and is considered a fundamental skill for all endoscopists who perform colonoscopy.A variety of polypectomy techniques and de...Polypectomy of colonic polyps has been shown to reduce the risk of colon cancer development and is considered a fundamental skill for all endoscopists who perform colonoscopy.A variety of polypectomy techniques and devices are available,and their use can vary greatly based on local availability and preferences.In general,cold forceps and cold snare have been the polypectomy methods of choice for smaller polyps,and hot snare has been the method of choice for larger polyps.The use of hot forceps has mostly fallen out of favor.Polypectomy for difficult to remove polyps may require the use of special devices and advanced techniques and has continued to evolve.As a result,the vast majority of polyps today can be removed endoscopically.Since electrocautery is frequently used for polypectomy,endoscopists should be thoroughly familiar with the basic principles of electrosurgery as it pertains to polypectomy.Tattooing of a polypectomy site is an important adjunct to polypectomy and can greatly facilitate future surgery or endoscopic surveillance.The two most common post-polypectomy complications are bleeding and perforation.Their incidence can be decreased with the use of meticulous polypectomy techniques and the application of some prophylactic maneuvers.This review will examine the technique of polypectomy and its complications from the perspective of the practicing gastroenterologist.展开更多
In immunoglobulin G4(IgG4)-related disease(RD),organ enlargement or nodular lesions consisting of abundant infiltration of lymphocytes and IgG4-positive plasma cells and fibrosis are seen in various organs.Although in...In immunoglobulin G4(IgG4)-related disease(RD),organ enlargement or nodular lesions consisting of abundant infiltration of lymphocytes and IgG4-positive plasma cells and fibrosis are seen in various organs.Although infiltration of many IgG4-positive plasma cells is detected in the gastric and colonic mucosa and major duodenal papilla of patients with autoimmune pancreatitis,it cannot be diagnosed as a gastrointestinal lesion involved in IgG4-RD,because none of the following is observed in these lesions:a mass-like formation;dense fibrosis;or obliterative phlebitis.Based on our review of the literature,there appear to be two types of IgG4-related gastrointestinal disease.One is a gastrointestinal lesion showing marked thickening of the wall of the esophagus and stomach,consisting of dense fibrosis with abundant infiltration of IgG4-positive plasma cells,which usually show submucosal spreading.The other is an IgG4-related pseudotumor occurring in gastrointestinal regions such as the stomach,colon,and major duodenal papilla,showing polypoid or mass-like lesions.Most solitary IgG4-related gastrointestinal lesions that are not associated with other IgG4-RD appear to be difficult to diagnose.It is of utmost importance to rule out malignancy.However,these lesions may respond to steroid therapy.To avoid unnecessary resection,IgG4-related gastrointestinal diseases should be considered in the differential diagnosis.展开更多
为比较内镜下氩离子凝固术与高频电凝切除术治疗结肠息肉的效果,为临床治疗结肠息肉提供指导,回顾2015年10月17日至2017年12月20日我院收治的87例结肠息肉患者资料,根据治疗方式的不同,将其分为试验组(内镜下氩离子凝固术治疗,40例)和...为比较内镜下氩离子凝固术与高频电凝切除术治疗结肠息肉的效果,为临床治疗结肠息肉提供指导,回顾2015年10月17日至2017年12月20日我院收治的87例结肠息肉患者资料,根据治疗方式的不同,将其分为试验组(内镜下氩离子凝固术治疗,40例)和对照组(内镜下高频电凝切除术治疗,47例)。对比2组患者的息肉切除情况、治愈率、术后并发症发生情况和复发率。结果显示,试验组息肉一次性切除率(94.74%)明显高于对照组(78.65%), P <0.05;试验组术后并发症发生率(10.00%)明显低于对照组(25.53%), P <0.05;试验组治愈率(95.00%)明显高于对照组(80.85%), P <0.05;治疗后3个月试验组复发率(10.00%)明显低于对照组(27.66%),P<0.05。结果表明,采取内镜下氩离子凝固术治疗结肠息肉效果优于内镜下高频电凝切除术,且术后并发症少,复发率低。展开更多
文摘Polypectomy of colonic polyps has been shown to reduce the risk of colon cancer development and is considered a fundamental skill for all endoscopists who perform colonoscopy.A variety of polypectomy techniques and devices are available,and their use can vary greatly based on local availability and preferences.In general,cold forceps and cold snare have been the polypectomy methods of choice for smaller polyps,and hot snare has been the method of choice for larger polyps.The use of hot forceps has mostly fallen out of favor.Polypectomy for difficult to remove polyps may require the use of special devices and advanced techniques and has continued to evolve.As a result,the vast majority of polyps today can be removed endoscopically.Since electrocautery is frequently used for polypectomy,endoscopists should be thoroughly familiar with the basic principles of electrosurgery as it pertains to polypectomy.Tattooing of a polypectomy site is an important adjunct to polypectomy and can greatly facilitate future surgery or endoscopic surveillance.The two most common post-polypectomy complications are bleeding and perforation.Their incidence can be decreased with the use of meticulous polypectomy techniques and the application of some prophylactic maneuvers.This review will examine the technique of polypectomy and its complications from the perspective of the practicing gastroenterologist.
基金Supported by Health and Labour Sciences Research Grants for Research on Intractable diseases(Research on IgG4-related disease)from Ministry of HealthLabour and Welfare of Japan
文摘In immunoglobulin G4(IgG4)-related disease(RD),organ enlargement or nodular lesions consisting of abundant infiltration of lymphocytes and IgG4-positive plasma cells and fibrosis are seen in various organs.Although infiltration of many IgG4-positive plasma cells is detected in the gastric and colonic mucosa and major duodenal papilla of patients with autoimmune pancreatitis,it cannot be diagnosed as a gastrointestinal lesion involved in IgG4-RD,because none of the following is observed in these lesions:a mass-like formation;dense fibrosis;or obliterative phlebitis.Based on our review of the literature,there appear to be two types of IgG4-related gastrointestinal disease.One is a gastrointestinal lesion showing marked thickening of the wall of the esophagus and stomach,consisting of dense fibrosis with abundant infiltration of IgG4-positive plasma cells,which usually show submucosal spreading.The other is an IgG4-related pseudotumor occurring in gastrointestinal regions such as the stomach,colon,and major duodenal papilla,showing polypoid or mass-like lesions.Most solitary IgG4-related gastrointestinal lesions that are not associated with other IgG4-RD appear to be difficult to diagnose.It is of utmost importance to rule out malignancy.However,these lesions may respond to steroid therapy.To avoid unnecessary resection,IgG4-related gastrointestinal diseases should be considered in the differential diagnosis.
文摘为比较内镜下氩离子凝固术与高频电凝切除术治疗结肠息肉的效果,为临床治疗结肠息肉提供指导,回顾2015年10月17日至2017年12月20日我院收治的87例结肠息肉患者资料,根据治疗方式的不同,将其分为试验组(内镜下氩离子凝固术治疗,40例)和对照组(内镜下高频电凝切除术治疗,47例)。对比2组患者的息肉切除情况、治愈率、术后并发症发生情况和复发率。结果显示,试验组息肉一次性切除率(94.74%)明显高于对照组(78.65%), P <0.05;试验组术后并发症发生率(10.00%)明显低于对照组(25.53%), P <0.05;试验组治愈率(95.00%)明显高于对照组(80.85%), P <0.05;治疗后3个月试验组复发率(10.00%)明显低于对照组(27.66%),P<0.05。结果表明,采取内镜下氩离子凝固术治疗结肠息肉效果优于内镜下高频电凝切除术,且术后并发症少,复发率低。
