Endoscopic Therapeutic Approach for Dysplasia in Inflammatory Bowel Disease
Clinical Endoscopy
;
: 437-445, 2017.
Artigo
em Inglês
| WPRIM
| ID: wpr-178248
ABSTRACT
Long-standing intestinal inflammation in patients with inflammatory bowel disease (IBD) induces dysplastic change in the intestinal mucosa and increases the risk of subsequent colorectal cancer. The evolving endoscopic techniques and technologies, including dye spraying methods and high-definition images, have been replacing random biopsies and have been revealed as more practical and efficient for detection of dysplasia in IBD patients. In addition, they have potential usefulness in detailed characterization of lesions and in the assessment of endoscopic resectability. Most dysplastic lesions without an unclear margin, definite ulceration, non-lifting sign, and high index of malignant change with suspicion for lymph node or distant metastases can be removed endoscopically. However, endoscopic resection of dysplasia in chronic IBD patients is usually difficult because it is often complicated by submucosal fibrosis. In patients with dysplasias that demonstrate submucosa fibrosis or a large size (≥20 mm), endoscopic submucosal dissection (ESD) or ESD with snaring (simplified or hybrid ESD) is an alternative option and may avoid a colectomy. However, a standardized endoscopic therapeutic approach for dysplasia in IBD has not been established yet, and dedicated specialized endoscopists with interest in IBD are needed to fully investigate recent emerging techniques and technologies.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Úlcera
/
Biópsia
/
Fibrose
/
Neoplasias Colorretais
/
Doenças Inflamatórias Intestinais
/
Colectomia
/
Proteínas SNARE
/
Inflamação
/
Mucosa Intestinal
/
Linfonodos
Limite:
Humanos
Idioma:
Inglês
Revista:
Clinical Endoscopy
Ano de publicação:
2017
Tipo de documento:
Artigo
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