@article {Spadaccini1998作者={马可Spadaccini和迈克尔J和罗伯塔Maselli和Marhieu Pioche Pradeep班达里和J {\ ' r e} {} \ ' e米氏雅克Amyn哈吉和丹尼斯·杨和爱德华多铝青铜{\ ' e} niz菲利普卡明斯基米甲和赫尔穆特•Messmann Alberto herrero de Tejada和桑德罗Sferrazza鲍里斯Pekarek和杰罗姆Rivory苏菲Geyl信心Gulati和彼得Draganov和Neal Shahidi埃贾兹·侯赛因和卡罗拉正在她和Edoardo胡蜂属和安德里亚Iannone Asma Alkandari切萨雷·哈桑和亚历山德罗Repici},编辑= {},title = {non-curative内镜黏膜下剥离的临床结果早期结直肠癌},体积={71}={10},页面= {1998 - 2004}= {2022},doi = {10.1136 / gutjnl - 2020 - 323897},出版商= {BMJ出版集团},文摘={目的内镜黏膜下剥离(ESD)在治疗意图submucosa-invasive (T1)早期直肠癌(T1-CRCs)往往会导致随后的手术切除的组织学参数指示节点参与的风险更高。然而,在某些情况下,预期的收益可以抵消手术风险,建议一个更保守的方法。设计回顾性分析连续T1-CRC患者接受委托人在13个中心截至2019年加入(n = 3373)。案件风险高的节点参与(non-curative ESD: G3,粘膜下入侵\ > 1000 {\ textmu}, lymphovascular参与,出芽或不完整切除/ R1)进行分析,如果后续数据(内镜/成像),无论postendoscopic管理(后续vs手术)选择这些机构的多学科小组。并发症是分类根据Charlson发病率指数(CCI)。结果复发、死亡和疾病死亡率的两组。残留病率(RD)前切除站点和区域淋巴结在手术病例的评估以及后续随访组。结果的平滑肌瘤604例结直肠ESD治疗侵袭性癌症,207年non-curative切除术(34.3 \ %)(包括138名男性;平均年龄67.6 {\ textpm} 10.9年);在65.2 \ %的情况下,没有完整的切除(R1)来实现。的207例病例中,60.9 \ % (n = 126; median CCI: 3; IQR: 2{\textendash}4) underwent surgical treatment with RD in 19.8\% (25/126), while 39.1\% (n=81, median CCI: 5; IQR: 4{\textendash}6) were followed up by endoscopy in all cases. Patients in the follow-up group had a higher overall mortality (HR=3.95) due to non-CRC causes (n=9, mean survival after ESD 23.7{\textpm}13.7 months). During this follow-up time, tumour recurrence and disease-specific survival rates were not different between the groups (median follow-up 30 months; range: 6{\textendash}105).Conclusion Following ESD for a lesion at high risk of RD, follow-up only may be a reasonable choice in patients at high risk for surgery. Also, endoscopic resection quality should be improved.Trial registration number NCT03987828.Data are available upon reasonable request.}, issn = {0017-5749}, URL = {//www.marcconsult.com/content/71/10/1998}, eprint = {//www.marcconsult.com/content/71/10/1998.full.pdf}, journal = {Gut} }