Endoscopy and polyps-diagnostic and therapeutic advances in management
Endoscopy and polyps-diagnostic and therapeutic advances in management作者机构:Department of SurgeryMadigan Army Medical CenterMadigan Health SystemTacoma Division of Colon and Rectal SurgeryCase Western Reserve Medical Center Department of SurgeryUniversity of Cincinnati Division of Colon and Rectal SurgeryWeill Cornell Medical College Department of SurgeryHuntington Hospital/North Shore-LIJ Health System Department of SurgeryRiverview Plaza Riverview Medical CenterRed Bank Department of SurgeryLoyola University Health System Division of Colon and Rectal SurgeryUniversity of Massachusetts Memorial Medical Center
出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))
年 卷 期:2013年第19卷第27期
页 面:4277-4288页
核心收录:
学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题:Polyps Endoscopy Colonoscopy Endoscopic submucosal dissection Endoscopic mucosal resection Quality Combined endoscopic-laparoscopic resection Combined laparoscopic-endoscopic resection Combined endoscopic-laparoscopic surgery
摘 要:Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced ( 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options.