Colorectal polypectomy and endoscopic mucosal resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2024

被引：87

作者：

Ferlitsch, Monika ^{[1
,2
]}

Hassan, Cesare ^{[3
,4
]}

Bisschops, Raf ^{[5
]}

Bhandari, Pradeep ^{[6
]}

Dinis-Ribeiro, Mario ^{[7
,8
,9
]}

Risio, Mauro ^{[10
]}

Paspatis, Gregorios A. ^{[11
]}

Moss, Alan ^{[12
,13
]}

Libanio, Diogo ^{[7
,8
,9
]}

Lorenzo-Zuniga, Vincente ^{[14
,15
]}

Voiosu, Andrei M. ^{[16
,17
]}

Rutter, Matthew D. ^{[18
,19
]}

Pellise, Maria ^{[20
,21
]}

Moons, Leon M. G. ^{[22
]}

Probst, Andreas

Awadie, Halim ^{[23
]}

Amato, Arnaldo ^{[24
]}

Takeuchi, Yoji ^{[25
]}

Repici, Alessandro ^{[3
,4
]}

Rahmi, Gabriel ^{[26
,27
]}

Koecklin, Hugo U. ^{[28
,29
]}

Albeniz, Eduardo ^{[30
]}

Rockenbauer, Lisa-Maria ^{[1
]}

Waldmann, Elisabeth ^{[1
]}

Messmann, Helmut ^{[22
]}

Triantafyllou, Konstantinos ^{[31
]}

Jover, Rodrigo ^{[32
]}

Gralnek, Ian M. ^{[23
,33
]}

Dekker, Evelien ^{[34
]}

Bourke, Michael J. ^{[35
,36
]}

机构：

[1] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Waehringer Guertel 18-20, A-1090 Vienna, Austria

[2] Evangel Hosp, Dept Gastroenterol, Vienna, Austria

[3] Humanitas Univ, Dept Biomed Sci, Pieve Emanuele, Italy

[4] Humanitas Clin & Res Ctr IRCCS, Endoscopy Unit, Rozzano, Italy

[5] Katholieke Univ Leuven, Univ Hosp Leuven, Dept Gastroenterol & Hepatol, TARGID, Leuven, Belgium

[6] Portsmouth Hosp Univ NHS Trust, Dept Urol, Portsmouth, England

[7] Portuguese Oncol Inst Porto, Dept Gastroenterol, Porto, Portugal

[8] Univ Porto, Fac Med, MEDCIDS, Porto, Portugal

[9] Porto Comprehens Canc Ctr Porto CCC, Hlth Res Network, RISECI IPOP, Porto, Portugal

[10] Dept Pathol, Inst Canc Res & Treatment, Turin, Italy

[11] Venizeleio Gen Hosp, Dept Gastroenterol, Iraklion, Crete, Greece

[12] Western Hlth, Dept Gastroenterol, Melbourne, Australia

[13] Univ Melbourne, Melbourne Med Sch, Dept Med, Western Hlth, Melbourne, Australia

[14] La Fe Univ & Polytech Hosp IISLaFe, Endoscopy Unit, Valencia, Spain

[15] Catholic Univ Valencia, Dept Med, Valencia, Spain

[16] Colentina Clin Hosp, Gastroenterol Dept, Bucharest, Romania

[17] Carol Davila Univ Med & Pharm, Internal Med & Gastroenterol, Bucharest, Romania

[18] North Tees & Hartlepool NHS Fdn Trust, Stockton On Tees, England

[19] Newcastle Univ, Fac Med Sci, Dept Gastroenterol, Newcastle Upon Tyne, England

[20] Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Dept Gastroenterol, Barcelona, Spain

[21] Univ Barcelona, Ctr Invest Biomed Red Enfermedades Hepat & Digest, CIBEREHD, Barcelona, Spain

[22] Univ Klinikum Augsburg, Med Klin 3, Augsburg, Germany

[23] Emek Med Ctr, Ellen & Pinchas Mamber Inst Gastroenterol & Hepato, Afula, Israel

[24] Osped A Manzoni, Digest Endoscopy & Gastroenterol Dept, Lecce, Italy

[25] Gunma Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Gunma, Japan

[26] Hop Europeen Georges Pompidou, Hepatogastroenterol & Endoscopy Dept, Paris, France

[27] Ctr Univ Paris, Lab Rech Biochirurg, AP HP, Paris, France

[28] Hosp Badalona Germans Trias & Pujol, Badalona, Spain

[29] Teknon Med Ctr, Barcelona, Spain

[30] Univ Publ Navarra UPNA, Hosp Univ Navarra HUN, Gastroenterol Dept, Navarrabiomed,IdiSNA, Pamplona, Spain

[31] Natl & Kapodastrian Univ Athens, Attikon Univ Gen Hosp, Med Sch, Dept Propaedeut Internal Med 2.Hepatogastroenterol, Athens, Greece

[32] Univ Miguel Hernandez, Hosp Gen Univ Dr Balmis, Dept Med Clin, Serv Med Digest,Inst Invest Sanitaria ISABIAL, Alicante, Spain

[33] Technion Israel Inst Technol, Rappaport Fac Med, Hadera, Israel

[34] Amsterdam Univ Med Ctr, Dept Gastroenterol & Hepatol, Amsterdam, Netherlands

[35] Westmead Hosp, Dept Gastroenterol & Hepatol, Sydney, Australia

[36] Univ Sydney, Sydney, Australia

来源：

ENDOSCOPY | 2024年 / 56卷 / 07期

关键词：

COLD SNARE POLYPECTOMY; FULL-THICKNESS RESECTION; PEDUNCULATED COLONIC POLYPS; SESSILE SERRATED POLYPS; EN-BLOC RESECTION; SUBMUCOSAL DISSECTION; RISK STRATIFICATION; ADENOMA RECURRENCE; RECURRING ADENOMA; LOCAL RECURRENCE;

D O I：

10.1055/a-2304-3219

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Main Recommendations 1 ESGE recommends cold snare polypectomy (CSP), to include a clear margin of normal tissue (1-2mm) surrounding the polyp, for the removal of diminutive polyps (<= 5mm). Strong recommendation, high quality of evidence. 2 ESGE recommends against the use of cold biopsy forceps excision because of its high rate of incomplete resection. Strong recommendation, moderate quality of evidence. 3 ESGE recommends CSP, to include a clear margin of normal tissue (1-2mm) surrounding the polyp, for the removal of small polyps (6-9mm). Strong recommendation, high quality of evidence. 4 ESGE recommends hot snare polypectomy for the removal of nonpedunculated adenomatous polyps of 10-19mm in size. Strong recommendation, high quality of evidence. 5 ESGE recommends conventional (diathermy-based) endoscopic mucosal resection (EMR) for large (>= 20mm) nonpedunculated adenomatous polyps (LNPCPs). Strong recommendation, high quality of evidence. 6 ESGE suggests that underwater EMR can be considered an alternative to conventional hot EMR for the treatment of adenomatous LNPCPs. Weak recommendation, moderate quality of evidence. 7 Endoscopic submucosal dissection (ESD) may also be suggested as an alternative for removal of LNPCPs of >= 20mm in selected cases and in high-volume centers. Weak recommendation, low quality evidence. 8 ESGE recommends that, after piecemeal EMR of LNPCPs by hot snare, the resection margins should be treated by thermal ablation using snare-tip soft coagulation to prevent adenoma recurrence. Strong recommendation, high quality of evidence. 9 ESGE recommends (piecemeal) cold snare polypectomy or cold EMR for SSLs of all sizes without suspected dysplasia. Strong recommendation, moderate quality of evidence. 10 ESGE recommends prophylactic endoscopic clip closure of the mucosal defect after EMR of LNPCPs in the right colon to reduce to reduce the risk of delayed bleeding. Strong recommendation, high quality of evidence. 11 ESGE recommends that en bloc resection techniques, such as en bloc EMR, ESD, endoscopic intermuscular dissection, endoscopic full-thickness resection, or surgery should be the techniques of choice in cases with suspected superficial invasive carcinoma, which otherwise cannot be removed en bloc by standard polypectomy or EMR. Strong recommendation, moderate quality of evidence.

引用

页码：516 / 545

页数：30

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