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2023 | Endoskopie des Bauches und der Verdauungsorgane | OriginalPaper | Buchkapitel

1. Endoskopische Resektionsverfahren

verfasst von : Georg Kähler

Erschienen in: Therapeutische Endoskopie im Gastrointestinaltrakt

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die endoskopischen Resektionsverfahren sind sowohl in der Diagnostik als auch in der Therapie von großer Bedeutung. Ihr Schwierigkeitsgrad ist stark von Größe und Form der Läsion abhängig. Obwohl sich die Anwendung der einzelnen Verfahren in den verschiedenen Organen und Abschnitten des Gastrointestinaltraktes erheblich voneinander unterscheidet, werden die Verfahren hier unter dem übergeordneten technischen Aspekt ihrer Durchführung dargestellt; auf eventuelle organspezifische Besonderheiten wird im Text verwiesen.
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Zurück zum Zitat Li, D. F., et al. (2022). „Efficacy and safety of cold snare polypectomy for sessile serrated polyps >/= 10 mm: A systematic review and meta-analysis.“ Dig Liver Dis Li, D. F., et al. (2022). „Efficacy and safety of cold snare polypectomy for sessile serrated polyps >/= 10 mm: A systematic review and meta-analysis.“ Dig Liver Dis
Zurück zum Zitat BACKGROUND: Cold snare polypectomy (CSP) is a promising technique for the removal of sessile serrated polyps (SSPs) >/= 10 mm. However, the efficacy and safety of this technique remain undetermined. AIMS: We aimed to comprehensively evaluate the efficacy and safety of CSP for SSPs >/= 10 mm. METHODS: PubMed, EMBASE, Web of Science and Cochrane Library were searched up to January 2021. RESULTS: A total of 10 studies consisting of 1727 SSPs (range, 10–40 mm) from 1021 patients were included. The overall rates of technical success, adverse events (AEs) and residual SSPs were 100%, 0.7% and 2.9%, respectively. Subgroup analysis showed that the rates of technical success and AEs were comparable between CSP and cold endoscopic mucosal resection (EMR) (99.9% vs. 100% and 1.3% vs. 0.5%, respectively), between the proximal and distal colon (100% vs. 99.9% and 0.3% vs. 0, respectively), and between polyps of 10–19 mm and >/=20 mm (99.8% vs. 100% and 0.9% vs. 0, respectively). However, subgroup analysis showed that the rate of residual SSPs was slightly lower in CSP compared with cold EMR (1.3% vs. 3.9%), as well as in polyps of 10–19 mm compared with those >/=20 mm (3.1% vs. 4.7%). CONCLUSION: CSP was an effective and safe technique for removing SSPs >/= 10 mm BACKGROUND: Cold snare polypectomy (CSP) is a promising technique for the removal of sessile serrated polyps (SSPs) >/= 10 mm. However, the efficacy and safety of this technique remain undetermined. AIMS: We aimed to comprehensively evaluate the efficacy and safety of CSP for SSPs >/= 10 mm. METHODS: PubMed, EMBASE, Web of Science and Cochrane Library were searched up to January 2021. RESULTS: A total of 10 studies consisting of 1727 SSPs (range, 10–40 mm) from 1021 patients were included. The overall rates of technical success, adverse events (AEs) and residual SSPs were 100%, 0.7% and 2.9%, respectively. Subgroup analysis showed that the rates of technical success and AEs were comparable between CSP and cold endoscopic mucosal resection (EMR) (99.9% vs. 100% and 1.3% vs. 0.5%, respectively), between the proximal and distal colon (100% vs. 99.9% and 0.3% vs. 0, respectively), and between polyps of 10–19 mm and >/=20 mm (99.8% vs. 100% and 0.9% vs. 0, respectively). However, subgroup analysis showed that the rate of residual SSPs was slightly lower in CSP compared with cold EMR (1.3% vs. 3.9%), as well as in polyps of 10–19 mm compared with those >/=20 mm (3.1% vs. 4.7%). CONCLUSION: CSP was an effective and safe technique for removing SSPs >/= 10 mm
Zurück zum Zitat Wannhoff A et al (2022) Systematic review and meta-analysis on effectiveness and safety of the full-thickness resection device (FTRD) in the colon. Z Gastroenterol 60(5):741–752CrossRefPubMed Wannhoff A et al (2022) Systematic review and meta-analysis on effectiveness and safety of the full-thickness resection device (FTRD) in the colon. Z Gastroenterol 60(5):741–752CrossRefPubMed
Zurück zum Zitat BACKGROUND: Endoscopic full-thickness resection (EFTR) has expanded the possibilities of endoscopic resection. The full-thickness resection device (FTRD, Ovesco Endoscopy, Tubingen, Germany) combines a clip-based defect closure and snare resection in a single device. METHODS: Systematic review and meta-analysis on effectiveness and safety of the FTRD in the colon. RESULTS: A total of 26 studies (12 published as full-text articles and 14 conference papers) with 1538 FTRD procedures were included. The pooled estimate for reaching the target lesion was 96.1 % (95 % confidence interval [95 % CI]: 94.6–97.1) and 90.0 % (95 % CI: 87.0–92.3) for technically successful resection. Pooled estimate of histologically complete resection was 77.8 % (95 % CI: 74.7–80.6). Adverse events occurred at a pooled estimate rate of 8.0 % (95 % CI: 5.8–10.4). Pooled estimates for bleeding and perforation were 1.5 % (95 % CI: 0.3–3.3) and 0.3 % (95 % CI: 0.0–0.9), respectively. The rate for need of emergency surgery after FTRD was 1.0 % (95 % CI: 0.4–1.8). CONCLUSION: The use of the FTRD in the colon shows very high rates of technical success and complete resection (R0) as well as a low risk of adverse events. Emergency surgery after colonic FTRD resection is necessary in single cases only BACKGROUND: Endoscopic full-thickness resection (EFTR) has expanded the possibilities of endoscopic resection. The full-thickness resection device (FTRD, Ovesco Endoscopy, Tubingen, Germany) combines a clip-based defect closure and snare resection in a single device. METHODS: Systematic review and meta-analysis on effectiveness and safety of the FTRD in the colon. RESULTS: A total of 26 studies (12 published as full-text articles and 14 conference papers) with 1538 FTRD procedures were included. The pooled estimate for reaching the target lesion was 96.1 % (95 % confidence interval [95 % CI]: 94.6–97.1) and 90.0 % (95 % CI: 87.0–92.3) for technically successful resection. Pooled estimate of histologically complete resection was 77.8 % (95 % CI: 74.7–80.6). Adverse events occurred at a pooled estimate rate of 8.0 % (95 % CI: 5.8–10.4). Pooled estimates for bleeding and perforation were 1.5 % (95 % CI: 0.3–3.3) and 0.3 % (95 % CI: 0.0–0.9), respectively. The rate for need of emergency surgery after FTRD was 1.0 % (95 % CI: 0.4–1.8). CONCLUSION: The use of the FTRD in the colon shows very high rates of technical success and complete resection (R0) as well as a low risk of adverse events. Emergency surgery after colonic FTRD resection is necessary in single cases only
Metadaten
Titel
Endoskopische Resektionsverfahren
verfasst von
Georg Kähler
Copyright-Jahr
2023
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-65087-5_1

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