Q: How are precancerous lesions treated early?
A:
1) For small lesions with a diameter of <5 mm, it is recommended to use snare resection; Biopsy forceps can be considered.
2) For small lesions with a diameter of 6-9 mm, it is recommended to use snare resection, especially cold snare resection; In addition, endoscopic mucosal resection (EMR) may be considered for the management of difficult-to-remove lesions.
3) For protuberant lesions with a diameter of >10mm (Ip type, Isp type, I type, I type), it is recommended to choose a suitable snare resection according to the characteristics of the pedicle for treatment.
4) EMR treatment is recommended for flat type (Ia, Ib, Ic) and some Is-type lesions that can be completely resected in one setting. In principle, EMR can be used to resect the lesions in one lump with a maximum diameter of <20 mm.
5) Endoscopic submucosal dissection (ESD) is recommended for lesions with a maximum diameter of >20 mm that are difficult to undergo one-time complete resection using EMR, lesions with a negative lift sign, and lesions with a residual EMR of >10 mm or lesions that relapse after treatment and are difficult to undergo EMR treatment again. When ESD is indeed difficult to carry out due to technical difficulties, the use of fractional EMR (EPMR) may be considered for lesions with a maximum diameter of >20 mm.
Post time: Mar-10-2023