Background: Endoscopic resection of dysplastic lesions in early stages of cancer reduces mortality rates and is recommended by many national guidelines throughout the world. Snare polypectomy and endoscopic mucosal resection (EMR) are established techniques of polyp removal. The advantages of these methods are their relatively short procedure times and acceptable complication rates. The latter include delayed bleeding in 0.9% and a perforation risk of 0.4–1.3%, depending on the size and location of the resected lesion. EMR is a recent modification of endoscopic resection. A limited number of studies suggest that larger lesions can be removed en bloc with low complication rates and short procedure times. Novel techniques such as endoscopic submucosal dissection (ESD) are used to enhance en bloc resection rates for larger, flat, or sessile lesions. Endoscopic full-thickness resection (EFTR) is employed for non-lifting lesions or those not easily amenable to resection. Procedures such as ESD or EFTR are emerging standards for lesions inaccessible to EMR techniques. Summary: Endoscopic treatment is now regarded as first-line therapy for benign lesions. Key Message: Endoscopic resection of dysplastic lesions or early stages of cancer is recommended. A plethora of different techniques can be used dependent on the lesions.
Visc Med

中文翻译：

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目前消化道病变的内镜下切除技术：内镜下黏膜切除术、黏膜下剥离术和全层切除术

背景：内镜下切除癌症早期发育不良病变可降低死亡率，并被世界各地的许多国家指南推荐。圈套器息肉切除术和内窥镜黏膜切除术 (EMR) 是成熟的息肉切除技术。这些方法的优点是它们相对较短的手术时间和可接受的并发症发生率。后者包括 0.9% 的延迟出血和 0.4-1.3% 的穿孔风险，具体取决于切除病变的大小和位置。EMR 是内窥镜切除术的最新改进。有限数量的研究表明，较大的病变可以整块切除，并发症发生率低，手术时间短。新技术如内镜黏膜下剥离术 (ESD) 用于提高较大、扁平或无蒂病变的整体切除率。内窥镜全层切除术（EFTR）用于非提升病变或不易切除的病变。ESD 或 EFTR 等程序是 EMR 技术无法触及的病变的新兴标准。总结：内镜治疗现在被认为是良性病变的一线治疗。关键信息：建议内镜切除发育不良病变或早期癌症。可以根据病变使用多种不同的技术。
粘性医学