Endoscopic colorectal imaging and therapy

作者：de Melo Silvio W Jr; Wallace Michael B^*

来源：Current Opinion in Gastroenterology, 2011, 27(1): 54-60.

DOI：10.1097/MOG.0b013e328340b855

• chromoendoscopy
• confocal endomicroscopy
• endoscopic mucosal resection
• endoscopic submucosal resection
• high-definition colonoscopy

Purpose of review
Colorectal cancer screening and prevention is a pivotal element in every gastroenterologist practice. Recent advances in imaging technology and treatment opened the field for endoscopic management of large flat colorectal polyps and early cancer.
Recent findings
High-definition white light colonoscopy allowed for better characterization of colon polyps, particularly flat lesions. Chromoendoscopy facilitated the identification of colon polyps as well as better endoscopic polyp characterization, with strong correlation with final pathological diagnosis, opening the field of 'virtual' biopsy. One particular technology, confocal endomicroscopy can magnify an image approximately 1000 times resembling optical microscopy with very good correlation with histology. Endoscopic mucosal resection has gained great acceptance to manage flat colorectal polyps with the two major complications being bleeding and perforation, both now under 5% in experienced hands. Endoscopic submucosal resection was developed to increase enbloc resection (less residual disease) of a flat colorectal lesion but one has to accept a higher perforation rate around 10%.
Summary
Current technology allows for better polyp identification and characterization, which can be managed endoscopically.

• 出版日期2011-1